Provider Demographics
NPI:1497738850
Name:QUILLIAN, WARREN C (MD)
Entity Type:Individual
Prefix:
First Name:WARREN
Middle Name:C
Last Name:QUILLIAN
Suffix:
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 1:1490 PANTOPS MOUNTAIN PL STE 200
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTESVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:22911-4601
Mailing Address - Country:US
Mailing Address - Phone:434-979-4440
Mailing Address - Fax:
Practice Address - Street 1:1490 PANTOPS MOUNTAIN PL
Practice Address - Street 2:SUITE 200
Practice Address - City:CHARLOTTESVILLE
Practice Address - State:VA
Practice Address - Zip Code:22911-4601
Practice Address - Country:US
Practice Address - Phone:434-979-4440
Practice Address - Fax:434-979-4441
Is Sole Proprietor?:No
Enumeration Date:2005-11-21
Last Update Date:2022-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101230928207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA241522OtherALLIANCE
VA184379OtherSOUTHERN HEALTH
VA241522OtherMAMSI
VA436536OtherANTHEM
VA5120089001OtherCIGNA
VA54493OtherCOMMUNITY HEALTH
VA080008076Medicare PIN
VA184379OtherSOUTHERN HEALTH
VA5120089001OtherCIGNA