Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208000000X | Pediatrician | 0101034779 | VA |
NPI | 1003477621 |
---|---|
Provider Name | Dr. Deborah Williams Ward |
First Address | Henrico, VA 23238-4152 |
Second Address | Henrico, VA 23238-4152 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 25/06/2019 |
Last Update Date | 25/06/2019 |