MEDICARE: WILLIAM G FITZHUGH MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207V00000X	Obstetrics & Gynecology Physician	0101017922	VA

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	C09646	OTHER		MEDICARE GROUP NUMBER

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1093774648
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	WILLIAM G FITZHUGH MD

Provider Business Mailing Address
First Line	:	112 N BOULEVARD
Second Line	:
City	:	RICHMOND
State	:	VA
Zip	:	23220-4304
Country	:	US
Telephone Number	:	804-523-3712
Fax Number	:	804-523-7736

Provider Business Practice Location Address
First Line	:	112 N BOULEVARD
Second Line	:
City	:	RICHMOND
State	:	VA
Zip	:	23220-4304
Country	:	US
Telephone Number	:	804-523-3712
Fax Number	:	804-523-7736

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/22/2006
Last Update Date	:	02/28/2013

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