Provider Demographics
NPI:1386485738
Name:WILLIAMS, CHAROLETTA TOMONIA
Entity type:Individual
Prefix:
First Name:CHAROLETTA
Middle Name:TOMONIA
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1334 SULPHUR SPRING RD STE 207
Mailing Address - Street 2:
Mailing Address - City:ARBUTUS
Mailing Address - State:MD
Mailing Address - Zip Code:21227-2714
Mailing Address - Country:US
Mailing Address - Phone:667-335-4657
Mailing Address - Fax:
Practice Address - Street 1:1334 SULPHUR SPRING RD STE 207
Practice Address - Street 2:
Practice Address - City:ARBUTUS
Practice Address - State:MD
Practice Address - Zip Code:21227-2714
Practice Address - Country:US
Practice Address - Phone:667-335-4657
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-31
Last Update Date:2024-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD8081663266699246RP1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246RP1900XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyPhlebotomy