MEDICARE: STEPHEN H 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	16482	NE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	01-00109	OTHER	NE	UNITED HEALTH CARE
2	010017056	OTHER	NE	RAILROAD RETIREMENT
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	470616017	OTHER	NE	BLUE CROSS BLUE SHIELD
5	88009	OTHER	NE	COVENTRY

General Provider Information

NPI Number	:	1679530505
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	STEPHEN H WILLIAMS M.D.

Provider Business Mailing Address
First Line	:	9015 ARBOR ST
Second Line	:	SUITE 106
City	:	OMAHA
State	:	NE
Zip	:	68124-2056
Country	:	US
Telephone Number	:	402-391-6623
Fax Number	:	402-391-6983

Provider Business Practice Location Address
First Line	:	9015 ARBOR ST
Second Line	:	SUITE 106
City	:	OMAHA
State	:	NE
Zip	:	68124-2056
Country	:	US
Telephone Number	:	402-391-6623
Fax Number	:	402-391-6983

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

Provider Enumeration Date	:	04/26/2006
Last Update Date	:	01/11/2013

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