Willard, Jennifer M

Willard, Jennifer M is an individual health care provider with primary practice located at 201 E Matthews St , Matthews NC 28105-5027. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Adolescent Medicine, Allopathic & Osteopathic Physicians / Pediatrics. Allopathic & Osteopathic Physicians / Pediatrics is her primary health care specialty. Willard, Jennifer M can be contacted via phone (704) 847-0572.

Contact Information

Primary practice address
201 E Matthews St Matthews NC 28105-5027
Phone: (704) 847-0572
Fax: (704) 847-9760
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Adolescent Medicine 2080A0000X 9701657 North Carolina
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 9701657 North Carolina

Profile Details

NPI number 1750352423
LBN Legal business name Willard, Jennifer M
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 30th, 2006
Last updated Mar 18th, 2015 - about 11 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 1750352423 NPPES
North Carolina MEDICAID 891197N

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