Provider Demographics
NPI:1881830206
Name:MICHAEL D. WILLIAMS, PC
Entity Type:Organization
Organization Name:MICHAEL D. WILLIAMS, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:D
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:508-212-5730
Mailing Address - Street 1:3 SANDY HILL RD
Mailing Address - Street 2:
Mailing Address - City:MANSFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:02048-3246
Mailing Address - Country:US
Mailing Address - Phone:508-212-5730
Mailing Address - Fax:508-337-9338
Practice Address - Street 1:174 DEAN ST
Practice Address - Street 2:UNIT D
Practice Address - City:TAUNTON
Practice Address - State:MA
Practice Address - Zip Code:02780-2782
Practice Address - Country:US
Practice Address - Phone:508-212-5730
Practice Address - Fax:508-337-9338
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-01-07
Last Update Date:2010-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA7469103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty