Provider Demographics
NPI:1346429305
Name:FISHERWILLIAMS, LINDA (DO)
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:
Last Name:FISHERWILLIAMS
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2450 DELHI COMMERCE DR
Mailing Address - Street 2:SUITE 4
Mailing Address - City:HOLT
Mailing Address - State:MI
Mailing Address - Zip Code:48842-2193
Mailing Address - Country:US
Mailing Address - Phone:517-699-3820
Mailing Address - Fax:517-699-3824
Practice Address - Street 1:2450 DELHI COMMERCE DR
Practice Address - Street 2:SUITE 4
Practice Address - City:HOLT
Practice Address - State:MI
Practice Address - Zip Code:48842-2193
Practice Address - Country:US
Practice Address - Phone:517-699-3820
Practice Address - Fax:517-699-3824
Is Sole Proprietor?:No
Enumeration Date:2007-10-26
Last Update Date:2009-02-04
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI5101008410207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MILF008410OtherSTATE LIC #
MI0153311304OtherBCBS PIN
MIF10823Medicare UPIN
MI0C36084031Medicare PIN
MI5331014Medicare PIN