Basic Information
| Provider Information | |||||||||
| NPI: | 1659683746 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | WILLIAMS | ||||||||
| FirstName: | PUJA | ||||||||
| MiddleName: | PATEL | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | PATEL | ||||||||
| OtherFirstName: | PUJA | ||||||||
| OtherMiddleName: | DIPAK | ||||||||
| OtherNamePrefix: | DR. | ||||||||
| OtherNameSuffix: | |||||||||
| OtherCredential: | M.D. | ||||||||
| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | PO BOX 418283 | ||||||||
| Address2: | |||||||||
| City: | BOSTON | ||||||||
| State: | MA | ||||||||
| PostalCode: | 022418283 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7035581544 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 3800 RESERVOIR RD NW | ||||||||
| Address2: | G-CCC BUILDING | ||||||||
| City: | WASHINGTON | ||||||||
| State: | DC | ||||||||
| PostalCode: | 200072113 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2024442116 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/06/2010 | ||||||||
| LastUpdateDate: | 08/16/2016 | ||||||||
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| NPIReactivationDate: | |||||||||
| ProviderGenderCode: | F | ||||||||
| AuthorizedOfficialLastName: | |||||||||
| AuthorizedOfficialFirstName: | |||||||||
| AuthorizedOfficialMiddleName: | |||||||||
| AuthorizedOfficialTitleorPosition: | |||||||||
| AuthorizedOfficialTelephone: | |||||||||
| IsSoleProprietor: | Y | ||||||||
| IsOrganizationSubpart: | |||||||||
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| NPICertificationDate: | |||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207P00000X | 4301096985 | MI | N | Allopathic & Osteopathic Physicians | Emergency Medicine | 207P00000X | 2015-01753 | NC | Y | Allopathic & Osteopathic Physicians | Emergency Medicine | 207P00000X | D78679 | MD | N | Allopathic & Osteopathic Physicians | Emergency Medicine | 207P00000X | MD044222 | DC | N | Allopathic & Osteopathic Physicians | Emergency Medicine | 207P00000X | 38842 | SC | N | Allopathic & Osteopathic Physicians | Emergency Medicine | 207P00000X | 074562 | GA | N | Allopathic & Osteopathic Physicians | Emergency Medicine |
No ID Information.