Provider Demographics
NPI:1548223951
Name:WILLIAMS, DAVID L (MD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:L
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:PO BOX 3290
Mailing Address - Street 2:
Mailing Address - City:PINEHURST
Mailing Address - State:NC
Mailing Address - Zip Code:28374-3290
Mailing Address - Country:US
Mailing Address - Phone:910-692-4593
Mailing Address - Fax:
Practice Address - Street 1:300 BLAKE BLVD
Practice Address - Street 2:
Practice Address - City:PINEHURST
Practice Address - State:NC
Practice Address - Zip Code:28374-8474
Practice Address - Country:US
Practice Address - Phone:910-692-4593
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-04-07
Last Update Date:2010-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC16754207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC87677OtherBLUE CROSS BLUE SHIELD
NC8987677Medicaid
NC87677OtherBLUE CROSS BLUE SHIELD
NC8987677Medicaid
NC211562Medicare PIN
NC1049Medicare PIN
NCC87178Medicare UPIN