Provider Demographics
NPI:1104908177
Name:WILLIAMS, ALAN CHRISTIAN (DC)
Entity type:Individual
Prefix:DR
First Name:ALAN
Middle Name:CHRISTIAN
Last Name:WILLIAMS
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:554 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:SOUTH PORTLAND
Mailing Address - State:ME
Mailing Address - Zip Code:04106-5407
Mailing Address - Country:US
Mailing Address - Phone:207-773-6425
Mailing Address - Fax:
Practice Address - Street 1:554 MAIN ST
Practice Address - Street 2:
Practice Address - City:SOUTH PORTLAND
Practice Address - State:ME
Practice Address - Zip Code:04106-5407
Practice Address - Country:US
Practice Address - Phone:207-773-6425
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MECR616111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MEW0412OtherANTHEM BCBS
MET31300Medicare UPIN
MEMM0336Medicare ID - Type Unspecified