Provider Demographics
NPI:1063682227
Name:NORALEAN WILLIAMS,MD,PA
Entity Type:Organization
Organization Name:NORALEAN WILLIAMS,MD,PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:NORALEAN
Authorized Official - Middle Name:
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:910-483-7506
Mailing Address - Street 1:705 CUMBERLAND ST
Mailing Address - Street 2:#A
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28301-7020
Mailing Address - Country:US
Mailing Address - Phone:910-483-7506
Mailing Address - Fax:910-483-1749
Practice Address - Street 1:705 CUMBERLAND ST
Practice Address - Street 2:#A
Practice Address - City:FAYETTEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28301-7020
Practice Address - Country:US
Practice Address - Phone:910-483-7506
Practice Address - Fax:910-483-1749
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-04
Last Update Date:2008-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC20364261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCC80810Medicare UPIN