Provider Demographics
NPI:1730955766
Name:WILLIAMS, MYRIAH KEMEH-KUA (MED)
Entity type:Individual
Prefix:
First Name:MYRIAH
Middle Name:KEMEH-KUA
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:MED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5987 TASMANINA DR.
Mailing Address - Street 2:
Mailing Address - City:LOWELL
Mailing Address - State:MI
Mailing Address - Zip Code:49331
Mailing Address - Country:US
Mailing Address - Phone:616-446-1529
Mailing Address - Fax:
Practice Address - Street 1:5987 TASMANINA DR.
Practice Address - Street 2:
Practice Address - City:LOWELL
Practice Address - State:MI
Practice Address - Zip Code:49331
Practice Address - Country:US
Practice Address - Phone:616-446-1529
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-11-30
Last Update Date:2023-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI374J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula