Provider Demographics
NPI:1942280029
Name:WILLIAMS, MICHAEL GLENN (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:GLENN
Last Name:WILLIAMS
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:106 GRAYSON CT
Mailing Address - Street 2:
Mailing Address - City:BEAUFORT
Mailing Address - State:NC
Mailing Address - Zip Code:28516-8906
Mailing Address - Country:US
Mailing Address - Phone:252-838-0116
Mailing Address - Fax:
Practice Address - Street 1:NAVAL HOSPITAL CHERRY POINT
Practice Address - Street 2:BUILDING 4389
Practice Address - City:CHERRY POINT
Practice Address - State:NC
Practice Address - Zip Code:28533-5008
Practice Address - Country:US
Practice Address - Phone:252-466-0254
Practice Address - Fax:252-466-0287
Is Sole Proprietor?:No
Enumeration Date:2006-01-17
Last Update Date:2016-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC11064183500000X, 1835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
No183500000XPharmacy Service ProvidersPharmacist