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NPI Code Detail

MEDICARE: DR. MAIA RENEE WILLIAMS PHARMD

MEDICARE: DR. MAIA RENEE WILLIAMS PHARMD
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
1183500000XPharmacist124361MN

General Provider Information

NPI Number : 1932761145
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MAIA RENEE WILLIAMS PHARMD
Provider Business Mailing Address
First Line : 2650 HENNEPIN AVE
Second Line :
City : MINNEAPOLIS
State : MN
Zip : 55408-1149
Country : US
Telephone Number : 612-377-3308
Fax Number : 612-377-5670
Provider Business Practice Location Address
First Line : 2650 HENNEPIN AVE
Second Line :
City : MINNEAPOLIS
State : MN
Zip : 55408-1149
Country : US
Telephone Number : 612-377-3308
Fax Number : 612-377-5670
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/08/2019
Last Update Date : 07/08/2019

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