Individual
GINA L WILLIAMS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
248 FLANDERS RD, NIANTIC, CT 06357-1264
(860) 739-5426
(860) 739-0063
Mailing address
248 FLANDERS RD, NIANTIC, CT 06357-1264
(860) 739-5426
(860) 739-0063
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
049525
CT
207Q00000X
Family Medicine Physician
MD12263
HI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
121813
MEDICARE FQHC
—
05
—
51864901
—
HI
Enumeration date
12/20/2005
Last updated
11/13/2012
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