Individual
DR. STACY J WILLIAMS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
1500 N 28TH ST, EMERGENCY MEDICINE DEPARTMENT, RICHMOND, VA 23223-5332
(804) 225-1780
(804) 225-1705
Mailing address
38935 ANN ARBOR RD, CREDENTIALING/PAYER CONTRACTING, LIVONIA, MI 48150-3397
(734) 632-0175
(734) 632-0182
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
0102202248
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0158204604
BCBS
MI
05
—
1083693972
—
MI
05
—
1083693972
—
VA
Enumeration date
01/10/2006
Last updated
03/12/2013
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