Provider Demographics
NPI:1699797324
Name:WEBB, WILLIAM EDWIN (MD)
Entity type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:EDWIN
Last Name:WEBB
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:10055 FORD AVE
Mailing Address - Street 2:SUITE 4A
Mailing Address - City:RICHMOND HILL
Mailing Address - State:GA
Mailing Address - Zip Code:31324-3972
Mailing Address - Country:US
Mailing Address - Phone:912-756-3075
Mailing Address - Fax:912-756-5291
Practice Address - Street 1:10055 FORD AVE
Practice Address - Street 2:SUITE 4A
Practice Address - City:RICHMOND HILL
Practice Address - State:GA
Practice Address - Zip Code:31324-3972
Practice Address - Country:US
Practice Address - Phone:912-756-3075
Practice Address - Fax:912-756-5291
Is Sole Proprietor?:No
Enumeration Date:2006-07-24
Last Update Date:2010-01-14
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GA058238208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCG58238Medicaid
GA887129756AMedicaid
SCG58238Medicaid