Provider Demographics
NPI:1083645766
Name:WILLIAMS, SANKEY V (MD)
Entity Type:Individual
Prefix:
First Name:SANKEY
Middle Name:V
Last Name:WILLIAMS
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 1:3701 MARKET ST
Mailing Address - Street 2:SUITE 640 6TH FLOOR
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19104-5502
Mailing Address - Country:US
Mailing Address - Phone:215-662-3795
Mailing Address - Fax:215-349-5091
Practice Address - Street 1:3701 MARKET ST
Practice Address - Street 2:STE 640 6TH FL
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19104-5502
Practice Address - Country:US
Practice Address - Phone:215-662-3795
Practice Address - Fax:215-349-5091
Is Sole Proprietor?:No
Enumeration Date:2006-07-05
Last Update Date:2012-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD013088E207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA000663200002Medicaid
C32880Medicare UPIN
PA178017Medicare PIN