Provider Demographics
NPI:1346201126
Name:WILLIAMS, ANASTASIA L (MD)
Entity Type:Individual
Prefix:MRS
First Name:ANASTASIA
Middle Name:L
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 60447
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28260-0447
Mailing Address - Country:US
Mailing Address - Phone:844-266-8268
Mailing Address - Fax:
Practice Address - Street 1:8180 STONEWALL SHOPS SQ
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:VA
Practice Address - Zip Code:20155-3891
Practice Address - Country:US
Practice Address - Phone:703-365-0227
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-03-31
Last Update Date:2020-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101230823208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA10231464OtherAMERIGROUP
234900OtherKAISER
283358OtherAMERIGROUP
VA010057485Medicaid
104124OtherANTHEM HEALTHKEEPERS
8121798OtherMAMSI OPTIMUM CHOICEMDIPA
VA8121798OtherALLIANCE
2616290OtherAETNA HMO POS
VA7137266OtherAETNA PPO
104124OtherANTHEM BCBC
J76300001OtherCAREFIRST
8121798OtherMAMSI OPTIMUM CHOICEMDIPA