Individual
DR. TROY ROBERT KEONI WILLIAMS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
11012 E 13 MILE RD, SUITE 112, WARREN, MI 48093-2572
(586) 573-6880
(586) 573-2562
Mailing address
29900 LORRAINE AVE, SUITE 400, WARREN, MI 48093-5266
(586) 582-0864
(586) 582-0964
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
4301086207
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0951909
BCBS PIN
MI
01
—
0E06376
MEDICARE GROUP NUMBER
MI
01
—
1184828451
FACILITY NPI
MI
05
—
1821209495
—
MI
01
—
700E063760
BCBS OF MICHIGAN GROUP NUMBER
MI
Enumeration date
05/25/2007
Last updated
11/08/2013
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