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General NPI Number Information
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NPI Number | 1386696607
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Entity Type | Individual
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Provider Name | WINFIELD ANTHONY YOUNG MD
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Gender | Male
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Dates
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Enumeration Date | 05/16/2006
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Last Update Date | 09/12/2012
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Provider Practice Location Address
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Address Line | 1212 LAKE JAMES DR STE C
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City | VIRGINIA BEACH
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State | VA
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Zip | 23464-6779
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Country | US
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Telephone | 757-523-4589
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Fax | 757-523-8920
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Provider Business Mailing Address
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Address Line | 1212 LAKE JAMES DR STE C
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City | VIRGINIA BEACH
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State | VA
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Zip | 23464-6779
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Country | US
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Telephone | 757-523-4589
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Fax | 757-523-8920
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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 | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 0101040247
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License Number State | VA
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