Provider Demographics
NPI:1982709481
Name:WILLIAMS, ROGER ANSON (MD)
Entity Type:Individual
Prefix:
First Name:ROGER
Middle Name:ANSON
Last Name:WILLIAMS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2402
Mailing Address - Street 2:
Mailing Address - City:CARMEL BY THE SEA
Mailing Address - State:CA
Mailing Address - Zip Code:93921-2402
Mailing Address - Country:US
Mailing Address - Phone:831-622-0991
Mailing Address - Fax:
Practice Address - Street 1:CARPENTER ST 2 NE OF THIRD
Practice Address - Street 2:
Practice Address - City:CARMEL BY THE SEA
Practice Address - State:CA
Practice Address - Zip Code:93921-2402
Practice Address - Country:US
Practice Address - Phone:831-622-0991
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAC30744207ZB0001X, 207ZP0213X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered207ZB0001XAllopathic & Osteopathic PhysiciansPathologyBlood Banking & Transfusion Medicine
Not Answered207ZP0213XAllopathic & Osteopathic PhysiciansPathologyPediatric Pathology