Healthcare Provider Details

I. General information

NPI: 1215669973
Provider Name (Legal Business Name): EMILY RUTH WILLIAMS DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: EMILY RUTH WOMBACHER

II. Dates (important events)

Enumeration Date: 06/29/2022
Last Update Date: 11/28/2025
Certification Date: 11/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

43480 YUKON DR STE 206
ASHBURN VA
20147-7335
US

IV. Provider business mailing address

43386 CHARITABLE ST
ASHBURN VA
20148-7575
US

V. Phone/Fax

Practice location:
  • Phone: 703-359-5100
  • Fax:
Mailing address:
  • Phone: 434-987-2023
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number0116037076
License Number StateVA
# 2
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number0102209700
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: