Provider Demographics
NPI:1861441214
Name:WILLIAMS, IFOR R (MD, PHD)
Entity Type:Individual
Prefix:
First Name:IFOR
Middle Name:R
Last Name:WILLIAMS
Suffix:
Gender:M
Credentials:MD, PHD
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Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:615 MICHAEL ST NE
Mailing Address - Street 2:WHITEHEAD BIOMEDICAL RESEARCH BLDG., RM. 105-D
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30322-1047
Mailing Address - Country:US
Mailing Address - Phone:404-727-8547
Mailing Address - Fax:404-727-8538
Practice Address - Street 1:615 MICHAEL ST NE
Practice Address - Street 2:WHITEHEAD BIOMEDICAL RESEARCH BLDG., RM. 105-D
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30322-1047
Practice Address - Country:US
Practice Address - Phone:404-727-8547
Practice Address - Fax:404-727-8538
Is Sole Proprietor?:No
Enumeration Date:2006-05-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GA044605207ZP0101X, 207ZI0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered207ZP0101XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology
Not Answered207ZI0100XAllopathic & Osteopathic PhysiciansPathologyImmunopathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAG54593Medicare UPIN