Saundra Annette Williams, MD
Individual provider Active NPI Internal Medicine Physician · East Ridge, TN
NPI 1780627240 · NPPES record last updated Apr 30, 2015
Key facts
- NPI
- 1780627240
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Internal Medicine Physician 207R00000X
- License
- 19023 (TN)
- Practice address
- 1508 Tombras Ave
East Ridge, TN 37412-2720 - Phone
- (423) 867-4969
- Fax
- (423) 867-4971
- NPI assigned
- Jun 13, 2006
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 19023 | TN | MD | Internal Medicine Physician |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 19023 | TN | Yes |
Addresses
Primary practice location
1508 Tombras Ave
East Ridge, TN 37412-2720
Mailing address
1508 Tombras Ave
East Ridge, TN 37412-2720
Phone (423) 867-4969
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 4241776 | Other | TN | BCBS - TENNESSEE |
| Q007543 | Medicaid | TN |
Other providers in East Ridge, TN
All providers in East Ridge, TN · Internal Medicine Physician in Tennessee
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 30, 2015. 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.