Provider Demographics
NPI:1578925533
Name:WILLIAMS, BIANCA MONDESIR (MD)
Entity Type:Individual
Prefix:DR
First Name:BIANCA
Middle Name:MONDESIR
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:BIANCA
Other - Middle Name:
Other - Last Name:MONDESIR
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:461 BERRYPATCH LN SE
Mailing Address - Street 2:
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30067-5072
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:5126 HOSPITAL DR NE
Practice Address - Street 2:
Practice Address - City:COVINGTON
Practice Address - State:GA
Practice Address - Zip Code:30014-2566
Practice Address - Country:US
Practice Address - Phone:770-385-4414
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-03-28
Last Update Date:2022-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD87279207P00000X
GA86324207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine