MEDICARE: DR. MALINDA A BROOKS-WILLIAMS M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	01010137725	VA

General Provider Information

NPI Number	:	1598777997
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MALINDA A BROOKS-WILLIAMS M.D.

Provider Business Mailing Address
First Line	:	PO BOX 758997
Second Line	:
City	:	BALTIMORE
State	:	MD
Zip	:	21275-0001
Country	:	US
Telephone Number	:	804-828-4842
Fax Number	:	804-828-2818

Provider Business Practice Location Address
First Line	:	4730 N SOUTHSIDE PLAZA ST
Second Line	:	FAMILY MEDICINE
City	:	RICHMOND
State	:	VA
Zip	:	23224-1742
Country	:	US
Telephone Number	:	804-230-7777
Fax Number	:	804-230-7798

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/13/2006
Last Update Date	:	08/26/2015

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