Provider Demographics
NPI:1891709242
Name:WILLIAMS, WINFRED WOODROW (MD)
Entity Type:Individual
Prefix:DR
First Name:WINFRED
Middle Name:WOODROW
Last Name:WILLIAMS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 9142
Mailing Address - Street 2:MASS GENERAL PHYSICIAN ORGANIZATION
Mailing Address - City:CHARLESTOWN
Mailing Address - State:MA
Mailing Address - Zip Code:02129-9142
Mailing Address - Country:US
Mailing Address - Phone:617-726-5050
Mailing Address - Fax:617-724-1122
Practice Address - Street 1:55 FRUIT STREET
Practice Address - Street 2:BUL 123
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02114-2696
Practice Address - Country:US
Practice Address - Phone:617-726-5050
Practice Address - Fax:617-724-1122
Is Sole Proprietor?:No
Enumeration Date:2006-07-28
Last Update Date:2012-11-12
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA49922207R00000X, 207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA3011909Medicaid
MA726044OtherTUFTS HEALTH PLAN
MAJ04902OtherBCBS MA
B74534Medicare UPIN
MA3011909Medicaid