1346201126 NPI number — MRS. ANASTASIA L WILLIAMS MD

Table of content: MRS. ANASTASIA L WILLIAMS MD (NPI 1346201126)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1346201126 NPI number — MRS. ANASTASIA L WILLIAMS MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
WILLIAMS
Provider First Name:
ANASTASIA
Provider Middle Name:
L
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1346201126
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
10/25/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 60447
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CHARLOTTE
Provider Business Mailing Address State Name:
NC
Provider Business Mailing Address Postal Code:
28260-0447
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
844-266-8268
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
8180 STONEWALL SHOPS SQ
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
GAINESVILLE
Provider Business Practice Location Address State Name:
VA
Provider Business Practice Location Address Postal Code:
20155-3891
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
703-365-0227
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
03/31/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 208000000X , with the licence number:  0101230823 , registered in the state of VA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 10231464 . This is a "AMERIGROUP" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 234900 . This is a "KAISER" identifier . This identifiers is of the category "OTHER".
  • Identifier: 283358 . This is a "AMERIGROUP" identifier . This identifiers is of the category "OTHER".
  • Identifier: 010057485 , issued by the state of ( VA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 104124 . This is a "ANTHEM HEALTHKEEPERS" identifier . This identifiers is of the category "OTHER".
  • Identifier: 8121798 . This is a "MAMSI OPTIMUM CHOICEMDIPA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 8121798 . This is a "ALLIANCE" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 2616290 . This is a "AETNA HMO POS" identifier . This identifiers is of the category "OTHER".
  • Identifier: 7137266 . This is a "AETNA PPO" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 104124 . This is a "ANTHEM BCBC" identifier . This identifiers is of the category "OTHER".
  • Identifier: J76300001 . This is a "CAREFIRST" identifier . This identifiers is of the category "OTHER".




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