Provider Demographics
NPI:1699843136
Name:WILLIAMS, CELESTE THOMAS (MD)
Entity Type:Individual
Prefix:
First Name:CELESTE
Middle Name:THOMAS
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:HENRY FORD HEALTH SYSTEM
Mailing Address - Street 2:2799 WEST GRAND BOULEVARD
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48202
Mailing Address - Country:US
Mailing Address - Phone:313-916-3887
Mailing Address - Fax:313-916-8901
Practice Address - Street 1:2799 W GRAND BLVD
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48202-2608
Practice Address - Country:US
Practice Address - Phone:313-916-3887
Practice Address - Fax:313-916-8901
Is Sole Proprietor?:No
Enumeration Date:2006-12-01
Last Update Date:2023-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301078317207R00000X, 207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CG078317OtherCHAMPUS-CHAMPUS
CG078317OtherCOMMERCIAL-COMMERCIAL NUMBER
060H264410OtherBLUE CROSS-BLUE CROSS
MI472455510Medicaid