Provider Demographics
NPI:1467415638
Name:CHEATHAM, WILLIAM LEE III (PA-C)
Entity Type:Individual
Prefix:MR
First Name:WILLIAM
Middle Name:LEE
Last Name:CHEATHAM
Suffix:III
Gender:M
Credentials:PA-C
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Mailing Address - Street 1:13853 TURNMORE RD
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20906-2135
Mailing Address - Country:US
Mailing Address - Phone:240-676-0785
Mailing Address - Fax:301-250-7617
Practice Address - Street 1:962 WAYNE AVE
Practice Address - Street 2:
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20910-4433
Practice Address - Country:US
Practice Address - Phone:240-744-0001
Practice Address - Fax:888-206-0912
Is Sole Proprietor?:No
Enumeration Date:2006-04-10
Last Update Date:2022-11-24
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Provider Licenses
StateLicense IDTaxonomies
MDC0001128363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical