Provider Demographics
NPI:1407193329
Name:WILLIAMS, ANDREW FREDERICK (MD)
Entity Type:Individual
Prefix:
First Name:ANDREW
Middle Name:FREDERICK
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 1:12032 BRASSIE BND
Mailing Address - Street 2:201
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33913-8177
Mailing Address - Country:US
Mailing Address - Phone:850-624-7062
Mailing Address - Fax:
Practice Address - Street 1:1601 E BROADWAY
Practice Address - Street 2:SUITE 100
Practice Address - City:COLUMBIA
Practice Address - State:MO
Practice Address - Zip Code:65201-8020
Practice Address - Country:US
Practice Address - Phone:573-443-8796
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-11
Last Update Date:2013-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO33524207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology