Basic Information
Provider Information
NPI: 1104959907
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: WILLIAMS
FirstName: DANIEL
MiddleName:  
NamePrefix: MR.
NameSuffix:  
Credential: CRNP
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1000 BOWER HILL ROAD
Address2: ST. CLAIR HOSPITAL - AFFILIATE BILLING - PAMALYN
City: PITTSBURGH
State: PA
PostalCode: 152431873
CountryCode: US
TelephoneNumber: 4129422548
FaxNumber:  
Practice Location
Address1: 1025 WASHINGTON PIKE STE 3
Address2:  
City: BRIDGEVILLE
State: PA
PostalCode: 150172702
CountryCode: US
TelephoneNumber: 4122213377
FaxNumber: 4122572744
Other Information
ProviderEnumerationDate: 03/13/2007
LastUpdateDate: 03/08/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 03/08/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363LF0000XSP008550PAY Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily

No ID Information.


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