Provider Demographics
NPI:1548767957
Name:WILLIAMS, WELARD JEWRON
Entity Type:Individual
Prefix:
First Name:WELARD
Middle Name:JEWRON
Last Name:WILLIAMS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:29 TODD PL NE
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20002-1334
Mailing Address - Country:US
Mailing Address - Phone:202-635-1009
Mailing Address - Fax:
Practice Address - Street 1:29 TODD PL NE
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20002-1334
Practice Address - Country:US
Practice Address - Phone:202-635-1009
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-04-11
Last Update Date:2023-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
171M00000X
DCHHA13675374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator