Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207W00000X | Ophthalmologist | 208460 | MA |
NPI | 1013965227 |
---|---|
Provider Name | Walter N Wills |
First Address | Alexandria, VA 22314-2944 |
Second Address | Alexandria, VA 22314-2944 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/05/2006 |
Last Update Date | 08/07/2007 |