Provider Demographics
NPI:1588313522
Name:WILLIAMS, SIEDA R
Entity type:Individual
Prefix:
First Name:SIEDA
Middle Name:R
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 1:6310 GREENSPRING AVE APT 308
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21209-5502
Mailing Address - Country:US
Mailing Address - Phone:443-522-1217
Mailing Address - Fax:
Practice Address - Street 1:3446 CONN AVE NW APT 104
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20008-1313
Practice Address - Country:US
Practice Address - Phone:202-362-3784
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-03-18
Last Update Date:2022-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant