Provider Demographics
NPI:1144468547
Name:WILLIAMS, COREY D (PHLEBOTOMIST)
Entity type:Individual
Prefix:MR
First Name:COREY
Middle Name:D
Last Name:WILLIAMS
Suffix:
Gender:M
Credentials:PHLEBOTOMIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9204 SWIVEN PL APT 1B
Mailing Address - Street 2:
Mailing Address - City:ROSEDALE
Mailing Address - State:MD
Mailing Address - Zip Code:21237-4387
Mailing Address - Country:US
Mailing Address - Phone:443-909-9994
Mailing Address - Fax:
Practice Address - Street 1:9204 SWIVEN PL APT 1B
Practice Address - Street 2:
Practice Address - City:ROSEDALE
Practice Address - State:MD
Practice Address - Zip Code:21237-4387
Practice Address - Country:US
Practice Address - Phone:443-909-9994
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-01-23
Last Update Date:2009-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD246RP1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246RP1900XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyPhlebotomy