Provider Demographics
NPI:1255313268
Name:WILLIAMSON, BRIAN D (MD)
Entity Type:Individual
Prefix:
First Name:BRIAN
Middle Name:D
Last Name:WILLIAMSON
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:4600 INVESTMENT DR
Mailing Address - Street 2:SUITE 200
Mailing Address - City:TROY
Mailing Address - State:MI
Mailing Address - Zip Code:48098-6365
Mailing Address - Country:US
Mailing Address - Phone:248-267-5050
Mailing Address - Fax:248-267-5051
Practice Address - Street 1:4600 INVESTMENT DR
Practice Address - Street 2:SUITE 200
Practice Address - City:TROY
Practice Address - State:MI
Practice Address - Zip Code:48098-6365
Practice Address - Country:US
Practice Address - Phone:248-267-5050
Practice Address - Fax:248-267-5051
Is Sole Proprietor?:No
Enumeration Date:2005-11-16
Last Update Date:2020-10-20
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MI4301407031207RC0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0001XAllopathic & Osteopathic PhysiciansInternal MedicineClinical Cardiac Electrophysiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0606344581OtherBLUE CROSS BLUE SHIELD OF MI
MI060069744OtherMEDICARE RAILROAD
MI4445236Medicaid
MIF55464Medicare UPIN
MI060069744OtherMEDICARE RAILROAD