Provider Demographics
NPI:1114089562
Name:WILLIAMS, MICHAEL ERLE (MD)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:ERLE
Last Name:WILLIAMS
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:280 MISSION DR
Mailing Address - Street 2:
Mailing Address - City:CAMARILLO
Mailing Address - State:CA
Mailing Address - Zip Code:93010-2024
Mailing Address - Country:US
Mailing Address - Phone:805-482-9916
Mailing Address - Fax:805-713-5300
Practice Address - Street 1:300 HILLMONT AVENUE, BLDG. 340, SUITE 401
Practice Address - Street 2:
Practice Address - City:VENTURA
Practice Address - State:CA
Practice Address - Zip Code:93003
Practice Address - Country:US
Practice Address - Phone:805-652-6201
Practice Address - Fax:805-641-4416
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-14
Last Update Date:2023-07-18
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAG12205208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G12205Medicaid
CAA38586Medicare UPIN