Provider Demographics
NPI:1013935485
Name:WILLIAMS, EDWARD S (NREMT-P)
Entity Type:Individual
Prefix:
First Name:EDWARD
Middle Name:S
Last Name:WILLIAMS
Suffix:
Gender:M
Credentials:NREMT-P
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 142
Mailing Address - Street 2:
Mailing Address - City:ELLERSLIE
Mailing Address - State:MD
Mailing Address - Zip Code:21529-0142
Mailing Address - Country:US
Mailing Address - Phone:301-722-2074
Mailing Address - Fax:
Practice Address - Street 1:14200 ELLERSLIE ROAD
Practice Address - Street 2:
Practice Address - City:ELLERSLIE
Practice Address - State:MD
Practice Address - Zip Code:21529-0237
Practice Address - Country:US
Practice Address - Phone:301-777-0959
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD0115863146L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes146L00000XEmergency Medical Service ProvidersEmergency Medical Technician, Paramedic