Provider Demographics
NPI:1184652091
Name:WILLIAMS, MICHAEL BRIAN (MD)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:BRIAN
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 1:994 DREW LN
Mailing Address - Street 2:
Mailing Address - City:AUBURN
Mailing Address - State:AL
Mailing Address - Zip Code:36830-4302
Mailing Address - Country:US
Mailing Address - Phone:334-821-1219
Mailing Address - Fax:334-821-0838
Practice Address - Street 1:994 DREW LN
Practice Address - Street 2:
Practice Address - City:AUBURN
Practice Address - State:AL
Practice Address - Zip Code:36830-4302
Practice Address - Country:US
Practice Address - Phone:334-821-1219
Practice Address - Fax:334-821-0838
Is Sole Proprietor?:No
Enumeration Date:2006-06-29
Last Update Date:2008-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL00016321207RC0000X, 207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL051076027OtherBCBS OF AL
AL000076027Medicaid
060047535OtherMEDICARE RAILROAD
AL529801770Medicaid
060047535OtherMEDICARE RAILROAD
ALE67534Medicare UPIN