Provider Demographics
NPI:1558473116
Name:WILLIAMS, KAMILAH MARIE (MD)
Entity type:Individual
Prefix:DR
First Name:KAMILAH
Middle Name:MARIE
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:KAMILAH
Other - Middle Name:MARIE
Other - Last Name:ABRAMS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:5450 FRANTZ RD
Mailing Address - Street 2:STE 250
Mailing Address - City:DUBLIN
Mailing Address - State:OH
Mailing Address - Zip Code:43016-4134
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:7340 E BROAD ST
Practice Address - Street 2:STE B
Practice Address - City:BLACKLICK
Practice Address - State:OH
Practice Address - Zip Code:43004-9625
Practice Address - Country:US
Practice Address - Phone:614-864-8000
Practice Address - Fax:614-864-3036
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2012-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35088005207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2680077Medicaid
OH4195342Medicare PIN
OHI63350Medicare UPIN