Provider Demographics
NPI:1619057734
Name:WILLIAMS, MARCUS R (MD)
Entity Type:Individual
Prefix:
First Name:MARCUS
Middle Name:R
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 1:80 W WELSH POOL RD
Mailing Address - Street 2:SUITE 101S
Mailing Address - City:EXTON
Mailing Address - State:PA
Mailing Address - Zip Code:19341-1233
Mailing Address - Country:US
Mailing Address - Phone:484-483-2745
Mailing Address - Fax:484-879-4098
Practice Address - Street 1:80 W WELSH POOL RD
Practice Address - Street 2:SUITE 101S
Practice Address - City:EXTON
Practice Address - State:PA
Practice Address - Zip Code:19341-1233
Practice Address - Country:US
Practice Address - Phone:484-483-2745
Practice Address - Fax:484-879-4098
Is Sole Proprietor?:No
Enumeration Date:2006-10-16
Last Update Date:2014-02-04
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAMD428872207R00000X
NH13610208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH30206557Medicaid
NH30206557Medicaid
NHC87188Medicare UPIN
P00412050Medicare PIN