Provider Demographics
NPI:1528689767
Name:WILLIAMS, AVIA
Entity type:Individual
Prefix:
First Name:AVIA
Middle Name:
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 1:1754 ARBOR GATE DR
Mailing Address - Street 2:
Mailing Address - City:LAWRENCEVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30044-8823
Mailing Address - Country:US
Mailing Address - Phone:833-982-4667
Mailing Address - Fax:833-471-3455
Practice Address - Street 1:1754 ARBOR GATE DR
Practice Address - Street 2:
Practice Address - City:LAWRENCEVILLE
Practice Address - State:GA
Practice Address - Zip Code:30044-8823
Practice Address - Country:US
Practice Address - Phone:833-982-4667
Practice Address - Fax:833-471-3455
Is Sole Proprietor?:No
Enumeration Date:2020-04-28
Last Update Date:2020-04-28
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246RP1900XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyPhlebotomy