Organization
DR MARK P WILLIAMS PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARK P WILLIAMS O.D. (OWNER/DOCTOR)
(810) 715-2020
Entity
Organization
Contact information
Practice address
4067 E COURT ST # 10-11, BURTON, MI 48509-2509
(810) 715-2020
Mailing address
4067 E COURT ST # 10-11, BURTON, MI 48509-2509
(810) 715-2020
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
202115
MCLAREN HEALTH PLAN
MI
05
—
5104868
—
MI
01
—
OB56586
BLUE CROSS/BLUE SHIELD OF MICHIGAN
MI
Enumeration date
08/04/2008
Last updated
08/26/2014
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