Provider Demographics
NPI:1508912486
Name:WILLIAMS, CAROL (MD)
Entity Type:Individual
Prefix:DR
First Name:CAROL
Middle Name:
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 1:9113 DICKEY DR
Mailing Address - Street 2:
Mailing Address - City:MECHANICSVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:23116-2502
Mailing Address - Country:US
Mailing Address - Phone:804-559-7280
Mailing Address - Fax:804-559-7282
Practice Address - Street 1:9113 DICKEY DR
Practice Address - Street 2:
Practice Address - City:MECHANICSVILLE
Practice Address - State:VA
Practice Address - Zip Code:23116-2502
Practice Address - Country:US
Practice Address - Phone:804-559-7280
Practice Address - Fax:804-559-7282
Is Sole Proprietor?:No
Enumeration Date:2007-01-25
Last Update Date:2022-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA01010504092080A0000X, 208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
No2080A0000XAllopathic & Osteopathic PhysiciansPediatricsAdolescent Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA542006346OtherFED TAX ID
VA006716211Medicaid
VAC06193OtherGROUP PTAN
VAC06115OtherGROUP PTAN