Provider Demographics
NPI:1972531424
Name:WILLIAMS, GERALD ROSS (MD)
Entity Type:Individual
Prefix:
First Name:GERALD
Middle Name:ROSS
Last Name:WILLIAMS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:833 CHESTNUT ST STE 520
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19107-4430
Mailing Address - Country:US
Mailing Address - Phone:800-321-9999
Mailing Address - Fax:267-339-3761
Practice Address - Street 1:825 OLD LANCASTER RD STE 100
Practice Address - Street 2:
Practice Address - City:BRYN MAWR
Practice Address - State:PA
Practice Address - Zip Code:19010-3234
Practice Address - Country:US
Practice Address - Phone:267-339-3558
Practice Address - Fax:673-393-7632
Is Sole Proprietor?:No
Enumeration Date:2006-06-30
Last Update Date:2022-03-01
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NJ25MA06546800207X00000X
FLME152883207X00000X
NY298602207X00000X
PAMD041888L207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
0448302000OtherIBC
C23512Medicare UPIN
PAP00448705Medicare PIN
PA619018GC6Medicare PIN