Individual
MARC HAROLD WILLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
300 PASTEUR DR, STANFORD, CA 94305-2200
(650) 723-4000
Mailing address
300 PASTEUR DR, STANFORD, CA 94305-2200
(650) 723-4000
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
20A17737
CA
2085R0202X
Diagnostic Radiology Physician
L4809
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
194794705
—
TX
05
—
194794707
—
TX
01
—
8BT621
BCBS
TX
Enumeration date
12/18/2006
Last updated
04/05/2024
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