Individual
DR. MICHAEL ANTHONY WILLIAMS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1604 MEADOWS LN, VIDALIA, GA 30474-8914
(912) 245-4179
(912) 403-3346
Mailing address
PO BOX 648, VIDALIA, GA 30475-0648
(912) 245-4179
(912) 403-3346
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
38650
GA
208D00000X
General Practice Physician
38650
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000600575F
—
GA
05
—
00600575C
—
GA
Enumeration date
03/28/2006
Last updated
05/17/2021
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