Provider Demographics
NPI:1194699793
Name:WILLIAMS, DOUGLAS STEVEN III
Entity type:Individual
Prefix:
First Name:DOUGLAS
Middle Name:STEVEN
Last Name:WILLIAMS
Suffix:III
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2401 BRIAR CREEK LN
Mailing Address - Street 2:
Mailing Address - City:BURTON
Mailing Address - State:MI
Mailing Address - Zip Code:48509-1396
Mailing Address - Country:US
Mailing Address - Phone:810-569-8206
Mailing Address - Fax:
Practice Address - Street 1:2401 BRIAR CREEK LN
Practice Address - Street 2:
Practice Address - City:BURTON
Practice Address - State:MI
Practice Address - Zip Code:48509-1396
Practice Address - Country:US
Practice Address - Phone:810-569-8206
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-10-06
Last Update Date:2025-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2002022146L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes146L00000XEmergency Medical Service ProvidersEmergency Medical Technician, Paramedic