Provider Demographics
NPI:1962693010
Name:WILLIAMS, MARTHA M (RPH)
Entity type:Individual
Prefix:MS
First Name:MARTHA
Middle Name:M
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:13133 N PORT WASHINGTON RD
Mailing Address - Street 2:G01
Mailing Address - City:MEQUON
Mailing Address - State:WI
Mailing Address - Zip Code:53097-2419
Mailing Address - Country:US
Mailing Address - Phone:262-243-6700
Mailing Address - Fax:262-243-6701
Practice Address - Street 1:13133 N PORT WASHINGTON RD
Practice Address - Street 2:G01
Practice Address - City:MEQUON
Practice Address - State:WI
Practice Address - Zip Code:53097-2419
Practice Address - Country:US
Practice Address - Phone:262-243-6700
Practice Address - Fax:262-243-6701
Is Sole Proprietor?:No
Enumeration Date:2007-08-05
Last Update Date:2010-03-26
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WI9440-040183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist