Provider Demographics
NPI:1790342426
Name:WILLIAMS, MICHAEL JR (PA)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:
Last Name:WILLIAMS
Suffix:JR
Gender:M
Credentials:PA
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Mailing Address - Street 1:11350 MCCORMICK RD
Mailing Address - Street 2:EXECUTIVE PLAZA 1, STE. 501
Mailing Address - City:HUNT VALLEY
Mailing Address - State:MD
Mailing Address - Zip Code:21031
Mailing Address - Country:US
Mailing Address - Phone:410-329-1071
Mailing Address - Fax:410-329-1054
Practice Address - Street 1:411 B PARK HILL DR
Practice Address - Street 2:
Practice Address - City:FREDERICKBURG
Practice Address - State:VA
Practice Address - Zip Code:22401
Practice Address - Country:US
Practice Address - Phone:540-368-3917
Practice Address - Fax:703-642-1876
Is Sole Proprietor?:No
Enumeration Date:2019-05-29
Last Update Date:2022-03-06
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant