Provider Demographics
NPI:1295780831
Name:WILLIAMS, PETER D (DO)
Entity type:Individual
Prefix:
First Name:PETER
Middle Name:D
Last Name:WILLIAMS
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:1001 MAIN ST STE K-3502
Mailing Address - Street 2:
Mailing Address - City:BUFFALO
Mailing Address - State:NY
Mailing Address - Zip Code:14203-1009
Mailing Address - Country:US
Mailing Address - Phone:716-323-6579
Mailing Address - Fax:716-323-6659
Practice Address - Street 1:ATWAL SURGERY CENTER
Practice Address - Street 2:3095 HARLEM RD
Practice Address - City:CHEEKTOWAGA
Practice Address - State:NY
Practice Address - Zip Code:14225-2500
Practice Address - Country:US
Practice Address - Phone:716-323-6579
Practice Address - Fax:716-323-6659
Is Sole Proprietor?:No
Enumeration Date:2006-05-23
Last Update Date:2024-01-31
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY238809207L00000X, 207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02758978Medicaid
NY02758978Medicaid