Provider Demographics
NPI:1932107661
Name:WILLIAMS, BARBARA LOUISE (MD)
Entity Type:Individual
Prefix:DR
First Name:BARBARA
Middle Name:LOUISE
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:707 N MICHIGAN ST
Mailing Address - Street 2:SUITE 115
Mailing Address - City:SOUTH BEND
Mailing Address - State:IN
Mailing Address - Zip Code:46601-1067
Mailing Address - Country:US
Mailing Address - Phone:574-233-8170
Mailing Address - Fax:574-273-1137
Practice Address - Street 1:707 N MICHIGAN ST
Practice Address - Street 2:SUITE 115
Practice Address - City:SOUTH BEND
Practice Address - State:IN
Practice Address - Zip Code:46601-1067
Practice Address - Country:US
Practice Address - Phone:574-233-8170
Practice Address - Fax:574-273-1137
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-07
Last Update Date:2009-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01037866207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN100091510Medicaid
IN100091510Medicaid
INE14956Medicare UPIN