Provider Demographics
NPI:1003854803
Name:MCWILLIAMS, SEAN M (MD)
Entity Type:Individual
Prefix:DR
First Name:SEAN
Middle Name:M
Last Name:MCWILLIAMS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2699
Mailing Address - Street 2:
Mailing Address - City:PENSACOLA
Mailing Address - State:FL
Mailing Address - Zip Code:32513-2699
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:7720 US HIGHWAY 98 W
Practice Address - Street 2:370
Practice Address - City:DESTIN
Practice Address - State:FL
Practice Address - Zip Code:32550-7230
Practice Address - Country:US
Practice Address - Phone:850-622-5148
Practice Address - Fax:850-622-5149
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-03
Last Update Date:2014-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME90138207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL2700786000Medicaid
FL43149ZMedicare ID - Type Unspecified
FLH61774Medicare UPIN