Provider Demographics
NPI:1073141347
Name:MACWILLIAM, AMBER NICOLE (DO)
Entity type:Individual
Prefix:
First Name:AMBER
Middle Name:NICOLE
Last Name:MACWILLIAM
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:AMBER
Other - Middle Name:NICOLE
Other - Last Name:MACWILLIAM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DO
Mailing Address - Street 1:PO BOX 5730
Mailing Address - Street 2:
Mailing Address - City:BELFAST
Mailing Address - State:ME
Mailing Address - Zip Code:04915-5700
Mailing Address - Country:US
Mailing Address - Phone:888-402-7256
Mailing Address - Fax:888-902-1099
Practice Address - Street 1:545 CREEKSIDE XING STE 230
Practice Address - Street 2:
Practice Address - City:NEW BRAUNFELS
Practice Address - State:TX
Practice Address - Zip Code:78130-7532
Practice Address - Country:US
Practice Address - Phone:830-302-4404
Practice Address - Fax:830-302-4407
Is Sole Proprietor?:No
Enumeration Date:2020-03-31
Last Update Date:2024-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXV2152207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology