Provider Demographics
NPI:1679968101
Name:WILLIAMS, WHITLEY (DPM)
Entity Type:Individual
Prefix:
First Name:WHITLEY
Middle Name:
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5801 ALLENTOWN RD STE 400
Mailing Address - Street 2:
Mailing Address - City:CAMP SPRINGS
Mailing Address - State:MD
Mailing Address - Zip Code:20746-4585
Mailing Address - Country:US
Mailing Address - Phone:301-868-0150
Mailing Address - Fax:301-868-0243
Practice Address - Street 1:5801 ALLENTOWN RD STE 4005801
Practice Address - Street 2:
Practice Address - City:CAMP SPRINGS
Practice Address - State:MD
Practice Address - Zip Code:20746-4563
Practice Address - Country:US
Practice Address - Phone:301-868-0150
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-04-01
Last Update Date:2022-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD01658213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD1679968101OtherNPI