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NPI Code Detail

MEDICARE: DR. IDA MICHELE WILLIAMS M.D.

MEDICARE: DR. IDA MICHELE 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
1208000000XPediatrics PhysicianMD 28038TN

General Provider Information

NPI Number : 1790848620
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. IDA MICHELE WILLIAMS M.D.
Provider Business Mailing Address
First Line : 1035 14TH AVE N
Second Line :
City : NASHVILLE
State : TN
Zip : 37208-3050
Country : US
Telephone Number : 615-327-9400
Fax Number : 615-340-1269
Provider Business Practice Location Address
First Line : 1035 14TH AVE N
Second Line :
City : NASHVILLE
State : TN
Zip : 37208-3050
Country : US
Telephone Number : 615-327-9400
Fax Number : 615-340-1269
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/19/2006
Last Update Date : 07/08/2007

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