Provider Demographics
NPI:1437180874
Name:WILLIAMS, RICHARD BRUCE (MD)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:BRUCE
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 1:292 SAINT CHARLES WAY
Mailing Address - Street 2:
Mailing Address - City:YORK
Mailing Address - State:PA
Mailing Address - Zip Code:17402
Mailing Address - Country:US
Mailing Address - Phone:717-851-6231
Mailing Address - Fax:717-851-6243
Practice Address - Street 1:292 SAINT CHARLES WAY
Practice Address - Street 2:
Practice Address - City:YORK
Practice Address - State:PA
Practice Address - Zip Code:17402
Practice Address - Country:US
Practice Address - Phone:717-851-6231
Practice Address - Fax:717-851-6243
Is Sole Proprietor?:No
Enumeration Date:2006-07-05
Last Update Date:2010-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD059762L207R00000X, 207RE0101X
GA021849207R00000X, 207RE0101X
MA77808207R00000X, 207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1304812OtherHIGHMARK BLUE SHIELD
PA001607528Medicaid
PA021933OtherJOHNS HOPKINS
PA7076083OtherAETNA
MD611195OtherCAREFIRST MD BCBS
PA1519837OtherGATEWAY-WMG
PA20900OtherGEISINGER
D70219Medicare UPIN
PA1519837OtherGATEWAY-WMG
MD611195OtherCAREFIRST MD BCBS