Provider Demographics
NPI:1134723349
Name:WILLIAMS, SUSANA M (PHARM D)
Entity type:Individual
Prefix:DR
First Name:SUSANA
Middle Name:M
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:9920 JONES BRIDGE RD
Mailing Address - Street 2:
Mailing Address - City:ALPHARETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30022-6522
Mailing Address - Country:US
Mailing Address - Phone:770-410-1755
Mailing Address - Fax:678-366-9855
Practice Address - Street 1:9920 JONES BRIDGE RD
Practice Address - Street 2:
Practice Address - City:ALPHARETTA
Practice Address - State:GA
Practice Address - Zip Code:30022-6522
Practice Address - Country:US
Practice Address - Phone:770-410-1755
Practice Address - Fax:678-366-9855
Is Sole Proprietor?:No
Enumeration Date:2020-11-28
Last Update Date:2020-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA025541183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA025541OtherGA PHARMACIST LICENSE