MEDICARE: CHARLES WILLIAMSON

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	207P00000X	Emergency Medicine Physician	39500	NC

General Provider Information

NPI Number	:	1881636025
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHARLES WILLIAMSON

Provider Business Mailing Address
First Line	:	3211 SHANNON RD
Second Line	:	SUITE 300
City	:	DURHAM
State	:	NC
Zip	:	27707-6322
Country	:	US
Telephone Number	:	800-291-4020
Fax Number	:	919-419-7247

Provider Business Practice Location Address
First Line	:	1010 COLLEGE ST
Second Line	:
City	:	OXFORD
State	:	NC
Zip	:	27565-2507
Country	:	US
Telephone Number	:	800-291-4020
Fax Number	:	919-419-7247

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

Provider Enumeration Date	:	06/12/2006
Last Update Date	:	07/08/2007

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Directions to “ CHARLES WILLIAMSON ” Practice Location

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