Provider Demographics
NPI:1245208230
Name:ABEL WILLIAMS, DIANE MARIE (PA C)
Entity Type:Individual
Prefix:MS
First Name:DIANE
Middle Name:MARIE
Last Name:ABEL WILLIAMS
Suffix:
Gender:F
Credentials:PA C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1265 N MILFORD RD
Mailing Address - Street 2:
Mailing Address - City:MILFORD
Mailing Address - State:MI
Mailing Address - Zip Code:48381
Mailing Address - Country:US
Mailing Address - Phone:248-685-3600
Mailing Address - Fax:248-685-0057
Practice Address - Street 1:1265 N MILFORD RD
Practice Address - Street 2:MILFORD FAMILY PRACTICE
Practice Address - City:MILFORD
Practice Address - State:MI
Practice Address - Zip Code:48381
Practice Address - Country:US
Practice Address - Phone:248-685-3600
Practice Address - Fax:248-685-0057
Is Sole Proprietor?:No
Enumeration Date:2006-03-08
Last Update Date:2010-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5601002254363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
OP9550002Medicare ID - Type Unspecified
P95010Medicare UPIN