Provider Demographics
NPI:1992792055
Name:WILLIAMS, MARGARET-MARY (MD)
Entity type:Individual
Prefix:
First Name:MARGARET-MARY
Middle Name:
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 PEARL ST
Mailing Address - Street 2:SUITE 1400
Mailing Address - City:BROCKTON
Mailing Address - State:MA
Mailing Address - Zip Code:02301-2864
Mailing Address - Country:US
Mailing Address - Phone:508-897-6200
Mailing Address - Fax:508-897-6321
Practice Address - Street 1:1 PEARL ST
Practice Address - Street 2:SUITE 1400
Practice Address - City:BROCKTON
Practice Address - State:MA
Practice Address - Zip Code:02301-2864
Practice Address - Country:US
Practice Address - Phone:508-897-6200
Practice Address - Fax:508-897-6321
Is Sole Proprietor?:No
Enumeration Date:2005-10-04
Last Update Date:2011-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA71259207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA3074749Medicaid
MA3074749Medicaid
MAJ11620Medicare ID - Type Unspecified