Williams, Malcolm Roderick
Williams, Malcolm Roderick is an sole proprietor health care provider with primary practice located at 558 Main St , South Portland ME 04106-5407. He recently has only one registered license in Chiropractic Providers / Chiropractor, which is considered as his primary health care specialty. Williams, Malcolm Roderick can be contacted via phone (207) 775-2265.Contact Information
Primary practice address
558 Main St
South Portland ME 04106-5407
Phone: (207) 775-2265
Fax: (207) 775-3743
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Chiropractic Providers / Chiropractor | 111N00000X | CR487 | Maine |
Profile Details
| NPI number | 1790840478 |
|---|---|
| LBN Legal business name | Williams, Malcolm Roderick |
| Credentials | Doctor of Chiropractic (DC) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Dec 24th, 2006 |
| Last updated | Oct 11th, 2023 - about last year |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1790840478 | NPPES |
| Maine | MEDICAID | 112800000 |
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