Provider Demographics
NPI:1275696015
Name:WILLIAMS, EDWIN SAXTON (MD)
Entity Type:Individual
Prefix:DR
First Name:EDWIN
Middle Name:SAXTON
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:PO BOX 75492
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21275-5492
Mailing Address - Country:US
Mailing Address - Phone:301-773-3752
Mailing Address - Fax:240-425-4636
Practice Address - Street 1:3300 PENNSYLVANIA AVE SE
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20020-2408
Practice Address - Country:US
Practice Address - Phone:202-583-1194
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-19
Last Update Date:2007-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCMD21688207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
DC034353100Medicaid
DC2214570OtherAETNA
DC865344OtherMAMSI
MD68715705OtherBCBS OF MD
MD820901400Medicaid
DC8702-0030OtherBCBS
MD820901400Medicaid
DC8702-0030OtherBCBS