Basic Information
Provider Information
NPI: 1467442632
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: WILLIAMS
FirstName: CHRISTY
MiddleName: MICHELLE
NamePrefix: DR.
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 133 LITTLETON RD
Address2: SUITE 205
City: WESTFORD
State: MA
PostalCode: 018863115
CountryCode: US
TelephoneNumber: 9783717010
FaxNumber:  
Practice Location
Address1: 133 LITTLETON RD
Address2: SUITE 205
City: WESTFORD
State: MA
PostalCode: 018863115
CountryCode: US
TelephoneNumber: 9783717010
FaxNumber:  
Other Information
ProviderEnumerationDate: 10/27/2005
LastUpdateDate: 05/05/2009
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207N00000X217307MAY Allopathic & Osteopathic PhysiciansDermatology 

No ID Information.


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