Provider Demographics
NPI:1861815862
Name:WILLIAMS, LAWRENCE SHELDON
Entity Type:Individual
Prefix:MR
First Name:LAWRENCE
Middle Name:SHELDON
Last Name:WILLIAMS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:28625 RANCHWOOD DR
Mailing Address - Street 2:
Mailing Address - City:SOUTHFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48076-2471
Mailing Address - Country:US
Mailing Address - Phone:248-996-9074
Mailing Address - Fax:248-996-9074
Practice Address - Street 1:28625 RANCHWOOD DR
Practice Address - Street 2:
Practice Address - City:SOUTHFIELD
Practice Address - State:MI
Practice Address - Zip Code:48076-2471
Practice Address - Country:US
Practice Address - Phone:248-996-9074
Practice Address - Fax:248-996-9074
Is Sole Proprietor?:Yes
Enumeration Date:2014-01-27
Last Update Date:2014-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIL2928343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)