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Individual

MR. PEVIN WILLIAMS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
CRNA

Contact information

Practice address
1638 OWEN DR, FAYETTEVILLE, NC 28304-3424
(910) 609-6440
(910) 609-5365
Mailing address
PO BOX 40908, FAYETTEVILLE, NC 28309-0908
(910) 609-6448
(910) 609-7040

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
149353
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
193259
MEDCOST
NC
05
8052601
NC
Enumeration date
09/20/2006
Last updated
02/14/2008
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