Individual
DR. SHELLEY WILLIAMS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
O.D.
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
TO2968
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000009118
MEDICARE GROUP
MO
01
—
108696
BCBS
MO
Enumeration date
05/31/2005
Last updated
02/25/2009
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