Provider Demographics
NPI:1487631107
Name:CUNDIFF, WILLIAM LINWOOD
Entity Type:Individual
Prefix:MR
First Name:WILLIAM
Middle Name:LINWOOD
Last Name:CUNDIFF
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4321 DAUGHERTY RD
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:VA
Mailing Address - Zip Code:24153-7993
Mailing Address - Country:US
Mailing Address - Phone:540-380-3279
Mailing Address - Fax:540-380-3221
Practice Address - Street 1:3737 W MAIN ST
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:VA
Practice Address - Zip Code:24153-2072
Practice Address - Country:US
Practice Address - Phone:540-380-4681
Practice Address - Fax:540-380-3221
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-12-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0202006364183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist