Ronel R. Williams, D.C.
Individual provider Active NPI Chiropractor · Mt Lake Park, MD
NPI 1174521728 · NPPES record last updated Feb 14, 2012
Key facts
- NPI
- 1174521728
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Chiropractor 111N00000X
- License
- 1108 (MD)
- Practice address
- 607 Oakland Ave
Mt Lake Park, MD 21550-3734 - Phone
- (301) 334-3160
- Fax
- (301) 334-3182
- NPI assigned
- Jul 8, 2005
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1108 | MD | MD | Chiropractor |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 1108 | MD | Yes |
| Chiropractor | 111N00000X | 366 | WV |
Addresses
Primary practice location
607 Oakland Ave
Mt Lake Park, MD 21550-3734
Mailing address
18505 Maryland Hwy
Swanton, MD 21561-1423
Phone (301) 359-3568
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| W2110001 | Other | MD | BLUE CHOICE |
| 329956 | Other | MAMSI | |
| 7016547 | Other | CIGNA | |
| 0131153000 | Medicaid | WV | |
| KBK4 | Other | CAREFIRST BC/BS | |
| W2110001 | Other | FEDERAL B/C | |
| 000174100 | Medicaid | MD |
Other providers in Mt Lake Park, MD
All providers in Mt Lake Park, MD · Chiropractor in Maryland
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 14, 2012. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.