Williams, Bruce Edward

Williams, Bruce Edward is an individual health care provider with primary practice located at 8120 Georgia St Suite B, Merrillville IN 46410-6390. He recently has 2 registered licenses in different health care specialties including Podiatric Medicine & Surgery Service Providers / Podiatrist, Podiatric Medicine & Surgery Service Providers / Foot & Ankle Surgery. Podiatric Medicine & Surgery Service Providers / Podiatrist is his primary health care specialty. Williams, Bruce Edward can be contacted via phone (847) 390-7666.

Contact Information

Primary practice address
8120 Georgia St Suite B Merrillville IN 46410-6390
Phone: (847) 390-7666
Fax: (847) 390-9345
Website:
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Health care specialties

SpecialtyCodeLicense #State
Podiatric Medicine & Surgery Service Providers / Podiatrist 213E00000X 07000747 Indiana
Podiatric Medicine & Surgery Service Providers / Foot & Ankle Surgery 213ES0103X 016004547 Illinois

Profile Details

NPI number 1689617508
LBN Legal business name Williams, Bruce Edward
Credentials Doctor of Podiatric Medicine (DPM)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 14th, 2006
Last updated Dec 14th, 2016 - about 10 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 1689617508 NPPES
Illinois MEDICAID 016004547
Illinois MEDICAID 100167720A

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