Provider Demographics
NPI:1902035256
Name:WILLIAMS, CARMEN M (MD)
Entity Type:Individual
Prefix:DR
First Name:CARMEN
Middle Name:M
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1730 ELTON RD
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20903-1723
Mailing Address - Country:US
Mailing Address - Phone:301-439-4302
Mailing Address - Fax:301-439-4340
Practice Address - Street 1:1730 ELTON RD
Practice Address - Street 2:
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20903-1723
Practice Address - Country:US
Practice Address - Phone:301-439-4302
Practice Address - Fax:301-439-4340
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-08
Last Update Date:2009-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD873168291U00000X
VA0101044545291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory