Provider Demographics
NPI:1164584512
Name:CAMILLE DAVIS-WILLIAMS, M.D., P.C.
Entity Type:Organization
Organization Name:CAMILLE DAVIS-WILLIAMS, M.D., P.C.
Other - Org Name:GREATER ATLANTA WOMEN'S HEALTHCARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CAMILLE
Authorized Official - Middle Name:
Authorized Official - Last Name:DAVIS-WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:404-589-2670
Mailing Address - Street 1:550 PEACHTREE ST NE
Mailing Address - Street 2:SUITE 1470
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30308-2247
Mailing Address - Country:US
Mailing Address - Phone:404-589-2670
Mailing Address - Fax:404-589-2671
Practice Address - Street 1:550 PEACHTREE ST NE
Practice Address - Street 2:SUITE 1470
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30308-2247
Practice Address - Country:US
Practice Address - Phone:404-589-2670
Practice Address - Fax:404-589-2671
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-14
Last Update Date:2010-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA25137207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA307761352AMedicaid
GA000430031DMedicaid
GA000308998BMedicaid
GAGRP2153Medicare ID - Type UnspecifiedCAMILLE DAVIS-WILLIAMSMDP
GAI14996Medicare UPIN
GAE98511Medicare UPIN
GA16BBCLFMedicare ID - Type UnspecifiedSABRINA HARRISON
GA260902448BMedicare ID - Type UnspecifiedCAMILLE DAVIS-WILLIAMS
GA307761352AMedicaid
GA000430031DMedicaid