Provider Demographics
NPI:1467517573
Name:DONALD H WILLIAMS MD PLLC
Entity Type:Organization
Organization Name:DONALD H WILLIAMS MD PLLC
Other - Org Name:DONALD H WILLIAMS MD PLLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PSYCHIATRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:DONALD
Authorized Official - Middle Name:H
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:517-332-8900
Mailing Address - Street 1:425 W GRAND RIVER AVE
Mailing Address - Street 2:
Mailing Address - City:EAST LANSING
Mailing Address - State:MI
Mailing Address - Zip Code:48823-4201
Mailing Address - Country:US
Mailing Address - Phone:517-332-8900
Mailing Address - Fax:517-351-2733
Practice Address - Street 1:425 W GRAND RIVER AVE
Practice Address - Street 2:
Practice Address - City:EAST LANSING
Practice Address - State:MI
Practice Address - Zip Code:48823-4201
Practice Address - Country:US
Practice Address - Phone:517-332-8900
Practice Address - Fax:517-351-2733
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-27
Last Update Date:2009-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIDW046913103TB0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TB0200XBehavioral Health & Social Service ProvidersPsychologistCognitive & BehavioralGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI2603320031OtherBLUE CROSS BLUE SHIELD
MI2603320031OtherBLUE CROSS BLUE SHIELD
MIE51794Medicare UPIN