Healthcare Provider Details

I. General information

NPI: 1558303453
Provider Name (Legal Business Name): JUDITH V WILLIAMS M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/12/2006
Last Update Date: 02/11/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

601 CHILDRENS LN
NORFOLK VA
23507-1910
US

IV. Provider business mailing address

PO BOX 79137
BALTIMORE MD
21279-0137
US

V. Phone/Fax

Practice location:
  • Phone: 757-668-8922
  • Fax: 757-668-8795
Mailing address:
  • Phone: 757-668-7200
  • Fax: 757-668-9691

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207NP0225X
TaxonomyPediatric Dermatology Physician
License Number0101229102
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: