MEDICARE: DENNIS WILLIAMS

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy	License Number State
1	374U00000X	Home Health Aide
2	376J00000X	Homemaker
3	374U00000X	Home Health Aide	MI

General Provider Information

NPI Number	:	1770328833
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DENNIS WILLIAMS

Provider Business Mailing Address
First Line	:	18879 SHIELDS ST
Second Line	:
City	:	DETROIT
State	:	MI
Zip	:	48234-2033
Country	:	US
Telephone Number	:	313-461-2920
Fax Number	:

Provider Business Practice Location Address
First Line	:	18879 SHIELDS ST
Second Line	:
City	:	DETROIT
State	:	MI
Zip	:	48234-2033
Country	:	US
Telephone Number	:	313-461-2920
Fax Number	:

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

Provider Enumeration Date	:	06/28/2024
Last Update Date	:	06/28/2024

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Directions to “ DENNIS WILLIAMS ” Practice Location

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