Provider Demographics
NPI:1336742600
Name:WILLIAMS, PORSHIA MICHAEL EBONY (PHARM D)
Entity Type:Individual
Prefix:
First Name:PORSHIA
Middle Name:MICHAEL EBONY
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5581 MERCHANTS VIEW SQ
Mailing Address - Street 2:
Mailing Address - City:HAYMARKET
Mailing Address - State:VA
Mailing Address - Zip Code:20169-5439
Mailing Address - Country:US
Mailing Address - Phone:410-931-7533
Mailing Address - Fax:
Practice Address - Street 1:7944 HONEYGO BLVD
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21236-4919
Practice Address - Country:US
Practice Address - Phone:410-931-7533
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-19
Last Update Date:2020-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD20456183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist