Bert Williams M.D. LLC

Primary specialty

Urology PhysicianTaxonomy code 208800000X

License

D0054397 Issued in MD

Legal business name

BERT WILLIAMS M.D. LLC

Practice address

97 Thomas Johnson Dr
Suite 102
Frederick, MD 21702-4379

Phone

(301) 694-0414

Fax

(301) 694-0415

NPI assigned

Oct 9, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Bert Edward Williams, M.D.NPI 1497813208

Title

Physician/Doctor

Phone

(301) 694-0414

Specialties & licenses 1

Addresses

Other names 1

• Mid-Maryland Urologic Services Doing business as

Medicare fee-for-service enrollment

Enrolled in MD

Enrollment records 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Bert Edward Williams, MD

  • Urology Physician
  • Frederick, MD
  • NPI 1497813208
  Medicare reassignment Authorized official
• Trevia F Hayden, M.D.

  • Forensic Psychiatry Physician
  • Frederick, MD
  • NPI 1598780603
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1191888000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1401321600000",
    "number": "1871781435",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "97 THOMAS JOHNSON DR",
            "address_2": "SUITE 102",
            "city": "FREDERICK",
            "state": "MD",
            "postal_code": "217024379",
            "telephone_number": "301-694-0414",
            "fax_number": "301-694-0415"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "97 THOMAS JOHNSON DR",
            "address_2": "SUITE 102",
            "city": "FREDERICK",
            "state": "MD",
            "postal_code": "217024379",
            "telephone_number": "301-694-0414",
            "fax_number": "301-694-0415"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BERT WILLIAMS M.D. LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-09",
        "last_updated": "2014-05-29",
        "status": "A",
        "authorized_official_last_name": "WILLIAMS",
        "authorized_official_first_name": "BERT",
        "authorized_official_middle_name": "EDWARD",
        "authorized_official_title_or_position": "PHYSICIAN/DOCTOR",
        "authorized_official_telephone_number": "301-694-0414",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Urology",
            "state": "MD",
            "license": "D0054397",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mid-Maryland Urologic Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Keisha Bernard, FNP-C
• Leny Vanessa Bernardo-Pollock, PA-C
• Lindsey Bernier
• Berry Chiropractic Center
• Donald Blake Berry, DC
• Kenneth Alvin Bertram, MD
• Best Options Services LLC
• Wendy E Betah, DNP, FNP-C, NRCME
• Jessica Chava Betaharon
• Obinna Bethrand-Okechukwu

• Urology Physician in Frederick, MD
• Providers in Frederick, MD by specialty
• Urology Physician in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.