Provider Demographics
NPI:1346481884
Name:WILLIAMS, CANDICE J (MD)
Entity type:Individual
Prefix:
First Name:CANDICE
Middle Name:J
Last Name:WILLIAMS
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:CANDICE
Other - Middle Name:J
Other - Last Name:BEREAL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:455 PHILIP BLVD STE 140
Mailing Address - Street 2:
Mailing Address - City:LAWRENCEVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30046-8768
Mailing Address - Country:US
Mailing Address - Phone:770-962-3642
Mailing Address - Fax:770-962-3643
Practice Address - Street 1:830 EAGLES LANDING PKWY STE 204
Practice Address - Street 2:
Practice Address - City:STOCKBRIDGE
Practice Address - State:GA
Practice Address - Zip Code:30281-7366
Practice Address - Country:US
Practice Address - Phone:770-962-3642
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-03-12
Last Update Date:2025-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA87909208VP0000X, 207LP2900X
CAA110292207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
Yes208VP0000XAllopathic & Osteopathic PhysiciansPain MedicinePain Medicine