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Deactivated NPI 1124404553 Deactivated / Inactive NPI Female Practitioner

Wanda Marie Williams

Contractor • Detroit, MI

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Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Wanda Williams has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date August 07, 2015
NPI Deactivation Date December 11, 2025
Total Practice Duration ~10 Years of Practice (2015 – 2025)

Professional Overview & Biography Verified Profile Summary

Wanda Williams was a registered Contractor practicing in Detroit, MI. Throughout an active medical career spanning 10 years, Wanda Williams provided care at the practice location at 4104 WOODHALL ST until profile deactivation on 2025-12-11.

Practice Location & Contact Primary Location

Practice Address

4104 Woodhall St

Detroit, MI 482242221

Telephone 3138212985

Specialty Benchmarks & Practice Insights

Comparative analytics for Contractor in Detroit, MI

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 22.0 Yrs
Regional Practice Density
61 Specialists

Practicing in Detroit, MI (262 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Contractor Primary Specialty

NUCC Taxonomy Code: 171W00000X

A person who contracts to supply certain materials or do certain work for a stipulated sum; esp., one whose business is contracting work in any of the building trades. For purposes of the taxonomy, a person who contracts to complete home repairs or modifications to accommodate a health condition (e.g. wheelchair ramp, kitchen counter lowering).

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

7 Historical Events
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NPI Profile Deactivated December 11, 2025

Record deactivated on December 11, 2025

NPI Profile Active August 07, 2015

NPI status registered as active in NPPES database

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Updated Practice Location August 07, 2015

Registered at 4104 WOODHALL ST, DETROIT, MI 482242221 (Tel: 3138212985)

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Updated Business Mailing Address August 07, 2015

Registered at 4104 WOODHALL ST, DETROIT, MI 482242221 (Tel: 3138212985)

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Provider Name / Credentials Updated August 07, 2015

Recorded as WANDA WILLIAMS

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Medical Taxonomy / Specialty Registered (Primary Specialty) August 07, 2015

Contractor

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Initial NPI Registration & Enumeration August 07, 2015

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1124404553
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: August 07, 2015
Last Update: August 07, 2015
Deactivation Date: December 11, 2025

Mailing Address

4104 Woodhall St

Detroit, MI 482242221

Phone: 3138212985

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.