Provider Demographics
NPI:1346356607
Name:WILLIAMS, ALAN LEWIS (MD)
Entity type:Individual
Prefix:
First Name:ALAN
Middle Name:LEWIS
Last Name:WILLIAMS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4301 JONES BRIDGE RD DEPT OF
Mailing Address - Street 2:
Mailing Address - City:BETHESDA
Mailing Address - State:MD
Mailing Address - Zip Code:20814-4712
Mailing Address - Country:US
Mailing Address - Phone:301-400-4073
Mailing Address - Fax:
Practice Address - Street 1:4301 JONES BRIDGE RD DEPT OF
Practice Address - Street 2:
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20814-4712
Practice Address - Country:US
Practice Address - Phone:301-400-4073
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-21
Last Update Date:2024-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0060551207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV15406OtherNEVADA STATE MEDICAL LICENSE
CAC53753OtherCA PHYSICIAN AND SURGEON LICENSE
MDM55181OtherSTATE CDS
MDD0060551OtherSTATE LICENSE
MDI01758Medicare UPIN