Provider Demographics
NPI:1558384438
Name:WILLIAMS, KAREN (MD)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:
Last Name:WILLIAMS
Suffix:
Gender:F
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:MARTHA'S VINEYARD HOSPITAL
Mailing Address - Street 2:1 HOSPITAL ROAD
Mailing Address - City:OAK BLUFFS
Mailing Address - State:MA
Mailing Address - Zip Code:02557
Mailing Address - Country:US
Mailing Address - Phone:508-693-3732
Mailing Address - Fax:856-541-3340
Practice Address - Street 1:MARTHA'S VINEYARD HOSPITAL
Practice Address - Street 2:1 HOSPITAL ROAD
Practice Address - City:OAK BLUFFS
Practice Address - State:MA
Practice Address - Zip Code:02557
Practice Address - Country:US
Practice Address - Phone:508-693-3732
Practice Address - Fax:508-790-6860
Is Sole Proprietor?:No
Enumeration Date:2006-07-25
Last Update Date:2018-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA270940208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ5341302Medicaid
NJF60015Medicare UPIN
NJ5341302Medicaid