Williams, Michael Derek

Williams, Michael Derek is an individual health care provider with primary practice located at 3100 Ne 28Th St Ste E , Lincoln City OR 97367-4524. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Surgery, Student, Health Care / Student in an Organized Health Care Education/Training Program. Allopathic & Osteopathic Physicians / Surgery is his primary health care specialty. Williams, Michael Derek can be contacted via phone (541) 994-8114.

Contact Information

Primary practice address
3100 Ne 28Th St Ste E Lincoln City OR 97367-4524
Phone: (541) 994-8114
Fax: (541) 994-5679
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Surgery 208600000X 53236 Minnesota
Student, Health Care / Student in an Organized Health Care Education/Training Program 390200000X
Allopathic & Osteopathic Physicians / Surgery 208600000X DO198440 Oregon

Profile Details

NPI number 1841524378
LBN Legal business name Williams, Michael Derek
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 1st, 2009
Last updated Nov 4th, 2020 - about 4 years ago

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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1841524378 NPPES
Minnesota MEDICAID ENROLLED

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