Provider Demographics
NPI:1093756348
Name:WILLIAMS, CYNTHIA SUZZANNE (MD)
Entity Type:Individual
Prefix:DR
First Name:CYNTHIA
Middle Name:SUZZANNE
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:CYNTHIA
Other - Middle Name:SUZZANNE
Other - Last Name:PRICE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:8325 E SOUTHPORT RD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46259-6805
Mailing Address - Country:US
Mailing Address - Phone:317-862-6609
Mailing Address - Fax:317-862-4617
Practice Address - Street 1:8325 E SOUTHPORT RD
Practice Address - Street 2:SUITE 100
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46259-6805
Practice Address - Country:US
Practice Address - Phone:317-862-6609
Practice Address - Fax:317-862-4617
Is Sole Proprietor?:No
Enumeration Date:2006-06-09
Last Update Date:2013-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01059453A207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
INI65405Medicare UPIN
IN247300AMedicare PIN