Individual
MR. JOHNATHAN DELEON WILLIAMS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
640 SUMMIT CROSSING PL, STE 204, GASTONIA, NC 28054-2142
(704) 865-0626
(704) 865-6531
Mailing address
640 SUMMIT CROSSING PL, STE 204, GASTONIA, NC 28054-2142
(704) 865-0626
(704) 865-6531
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
31957
NC
208000000X
Pediatrics Physician
31957
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8987659
—
NC
Enumeration date
01/27/2006
Last updated
10/23/2007
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