Provider Demographics
NPI:1467469171
Name:WILLIAMS, ROBERT MICHAEL (MD)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:MICHAEL
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 1:100 KINGSTON AVE
Mailing Address - Street 2:
Mailing Address - City:BARRINGTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08007-1114
Mailing Address - Country:US
Mailing Address - Phone:856-547-1177
Mailing Address - Fax:856-547-2509
Practice Address - Street 1:100 KINGSTON AVE
Practice Address - Street 2:
Practice Address - City:BARRINGTON
Practice Address - State:NJ
Practice Address - Zip Code:08007-1114
Practice Address - Country:US
Practice Address - Phone:856-547-1177
Practice Address - Fax:856-547-2509
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-02
Last Update Date:2010-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA039291207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0086142000OtherKEYSTONE HMO
NJ10459OtherAETNA
NJ000166396OtherHIGHMARK BS
NJP00015887OtherRAILROAD MEDICARE
NJ001590994OtherHIGHMARK BS
NJ2269011001OtherAMERIHEALTH HMO
NJP00015887OtherRAILROAD MEDICARE
NJ2269011001OtherAMERIHEALTH HMO