Provider Demographics
NPI:1407899404
Name:WILLIAMS, JOYCE MONICA (MD)
Entity type:Individual
Prefix:DR
First Name:JOYCE
Middle Name:MONICA
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:2449 GOLF RD
Mailing Address - Street 2:SUITE 11
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19131-1475
Mailing Address - Country:US
Mailing Address - Phone:215-878-1996
Mailing Address - Fax:215-878-2500
Practice Address - Street 1:2449 GOLF RD
Practice Address - Street 2:SUITE 11
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19131-1475
Practice Address - Country:US
Practice Address - Phone:215-878-1996
Practice Address - Fax:215-878-2500
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD420429204C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes204C00000XAllopathic & Osteopathic PhysiciansNeuromusculoskeletal Medicine, Sports Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1013344140091Medicaid
PAIBC 1723988OtherINDEPENDENCE BLUE CROSS
PAIBC 1723988OtherINDEPENDENCE BLUE CROSS
PAH77203Medicare UPIN