1538122312 NPI number — MEREDITH MINTO WILLIAMS MD

Table of content: DR. DAVID HANCOCK PHARM D (NPI 1770916439)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1538122312 NPI number — MEREDITH MINTO WILLIAMS MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
WILLIAMS
Provider First Name:
MEREDITH
Provider Middle Name:
MINTO
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1538122312
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/01/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
109 RAYLOC DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
HANCOCK
Provider Business Mailing Address State Name:
MD
Provider Business Mailing Address Postal Code:
21750-1518
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
301-678-5187
Provider Business Mailing Address Fax Number:
301-678-5797

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
130 W HIGH ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HANCOCK
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
21750-1143
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
301-678-7256
Provider Business Practice Location Address Fax Number:
301-678-6396
Provider Enumeration Date:
04/11/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 208000000X , with the licence number:  D0033525 , registered in the state of MD ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 208000000X , with the licence number: MD035262E , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 1538122312 . This is a "NPI" identifier . This identifiers is of the category "OTHER".
  • Identifier: 482501200 , issued by the state of ( MD ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1007288800006 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".




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