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General NPI Number Information
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NPI Number | 1235122151
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Entity Type | Individual
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Provider Name | WILLIAM FRED PRESTOWITZ MD
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Gender | Male
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Dates
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Enumeration Date | 08/25/2005
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Last Update Date | 05/05/2022
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Provider Practice Location Address
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Address Line | 340 W MAIN ST
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City | ABINGDON
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State | VA
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Zip | 24210-2624
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Country | US
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Telephone | 276-628-3118
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Fax | 276-628-8342
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Provider Business Mailing Address
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Address Line | 340 W MAIN ST
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City | ABINGDON
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State | VA
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Zip | 24210-2624
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Country | US
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Telephone | 276-628-3118
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Fax | 276-628-8342
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | 0101043622
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License Number State | VA
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