Provider Demographics
NPI:1508809252
Name:WILLIAMS, DANIEL E (MD)
Entity Type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:E
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 1:1540 LAKE LANSING RD
Mailing Address - Street 2:STE 103
Mailing Address - City:LANSING
Mailing Address - State:MI
Mailing Address - Zip Code:48912-3756
Mailing Address - Country:US
Mailing Address - Phone:517-913-3890
Mailing Address - Fax:517-913-3891
Practice Address - Street 1:1250 IDAHO ST
Practice Address - Street 2:
Practice Address - City:LEWISTON
Practice Address - State:ID
Practice Address - Zip Code:83501-1965
Practice Address - Country:US
Practice Address - Phone:208-743-7427
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-13
Last Update Date:2023-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301030881207RH0003X
IDMC-0528207RH0003X
IN01090600A207RX0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RX0202XAllopathic & Osteopathic PhysiciansInternal MedicineMedical Oncology
No207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1000914OtherMCLAREN HEALTH PLAN-MEDICAID
MI104833738Medicaid
MI1103300241OtherBCBS/BCN
MI0M76680001OtherMEDICARE ADVANTAGE
MI200000001034OtherPHP FAMILYCARE
MI900002953OtherRAILROAD MEDICARE
MI1000914OtherMCLAREN HEALTH ADVANTAGE
MI1103300241OtherHEALTHPLUS OF MICHIGAN
MI200000001034OtherPHP
MI3454811Medicaid
MI1000914OtherMCLAREN HEALTH PLAN-COMMERCIAL
MI3454830Medicaid
MI4062823OtherAETNA
MI4062823OtherAETNA
MI1103300241OtherHEALTHPLUS OF MICHIGAN
MI104833738Medicaid