Provider Demographics
NPI:1376688598
Name:FURLONG, WILLIAM BENEDICT JR (MD)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:BENEDICT
Last Name:FURLONG
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1635 NORTH GEORGE MASON DRIVE
Mailing Address - Street 2:SUITE 440
Mailing Address - City:ARLINGTON
Mailing Address - State:VA
Mailing Address - Zip Code:22205-3617
Mailing Address - Country:US
Mailing Address - Phone:703-525-7600
Mailing Address - Fax:703-516-4503
Practice Address - Street 1:1635 NORTH GEORGE MASON DRIVE
Practice Address - Street 2:SUITE 440
Practice Address - City:ARLINGTON
Practice Address - State:VA
Practice Address - Zip Code:22205-3617
Practice Address - Country:US
Practice Address - Phone:703-525-7600
Practice Address - Fax:703-516-4503
Is Sole Proprietor?:No
Enumeration Date:2007-02-21
Last Update Date:2019-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101047503207RI0200X
MDD0030694207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA006089054Medicaid
E63766Medicare UPIN