Provider Demographics
NPI:1134305048
Name:WILLIAMS FAMILY MEDICINE PC
Entity type:Organization
Organization Name:WILLIAMS FAMILY MEDICINE PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:H
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:609-652-2033
Mailing Address - Street 1:415 CHRIS GAUPP DR
Mailing Address - Street 2:SUITE C2
Mailing Address - City:GALLOWAY
Mailing Address - State:NJ
Mailing Address - Zip Code:08205-4440
Mailing Address - Country:US
Mailing Address - Phone:609-652-2033
Mailing Address - Fax:609-652-3318
Practice Address - Street 1:415 CHRIS GAUPP DR
Practice Address - Street 2:SUITE C2
Practice Address - City:GALLOWAY
Practice Address - State:NJ
Practice Address - Zip Code:08205-4440
Practice Address - Country:US
Practice Address - Phone:609-652-2033
Practice Address - Fax:609-652-3318
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-10
Last Update Date:2008-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA05833400207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJF46062Medicare UPIN