Provider Demographics
NPI:1316927981
Name:WILLIAMS, DEBRA MOMILANI (MD)
Entity type:Individual
Prefix:DR
First Name:DEBRA
Middle Name:MOMILANI
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:1650 COCHRANE CIR CREDENTIALS OFFICE
Mailing Address - Street 2:EVANS ARMY COMMUNITY HOSPITAL (EACH) USA MEDDAC
Mailing Address - City:FORT CARSON
Mailing Address - State:CO
Mailing Address - Zip Code:80913-4604
Mailing Address - Country:US
Mailing Address - Phone:719-526-7844
Mailing Address - Fax:719-526-7984
Practice Address - Street 1:EVANS ARMY COMMUNITY HOSPITAL (EACH) USA MEDDAC
Practice Address - Street 2:EACH PEDIATRIC CLINIC ROOM #1221
Practice Address - City:FORT CARSON
Practice Address - State:CO
Practice Address - Zip Code:80913-4604
Practice Address - Country:US
Practice Address - Phone:719-526-7653
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-01-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101054457208000000X
HIMD-9978208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered208000000XAllopathic & Osteopathic PhysiciansPediatrics