Provider Demographics
NPI:1538191259
Name:WILLIAMS, HIRAM STEPHEN (MD)
Entity type:Individual
Prefix:DR
First Name:HIRAM
Middle Name:STEPHEN
Last Name:WILLIAMS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:804 SERVICE RD # A201
Mailing Address - Street 2:
Mailing Address - City:EAST LANSING
Mailing Address - State:MI
Mailing Address - Zip Code:48824-7015
Mailing Address - Country:US
Mailing Address - Phone:517-884-2976
Mailing Address - Fax:517-432-3928
Practice Address - Street 1:1600 W GRAND RIVER AVE
Practice Address - Street 2:
Practice Address - City:OKEMOS
Practice Address - State:MI
Practice Address - Zip Code:48864-2394
Practice Address - Country:US
Practice Address - Phone:517-349-6560
Practice Address - Fax:517-349-5796
Is Sole Proprietor?:No
Enumeration Date:2006-07-06
Last Update Date:2016-08-22
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI4301059122208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4441219Medicaid
MI1538191259Medicaid
MI4441219Medicaid
MIC36082140Medicare PIN