Provider Demographics
NPI:1922042571
Name:WILLIAMS, ROBERT C (MD)
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:C
Last Name:WILLIAMS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3381 OAK ST
Mailing Address - Street 2:
Mailing Address - City:WHEAT RIDGE
Mailing Address - State:CO
Mailing Address - Zip Code:80033-5458
Mailing Address - Country:US
Mailing Address - Phone:303-997-9978
Mailing Address - Fax:
Practice Address - Street 1:8406 CLAY ST
Practice Address - Street 2:
Practice Address - City:WESTMINSTER
Practice Address - State:CO
Practice Address - Zip Code:80031-3810
Practice Address - Country:US
Practice Address - Phone:720-443-8461
Practice Address - Fax:303-427-4291
Is Sole Proprietor?:No
Enumeration Date:2006-06-15
Last Update Date:2016-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO17931207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL000018530Medicaid
100008520Medicare PIN
C72987Medicare UPIN
AL000018530Medicaid