Provider Demographics
NPI:1790784767
Name:REED, WILLIAM W (MD)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:W
Last Name:REED
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 1:160 KINGSLEY LN
Mailing Address - Street 2:STE 505
Mailing Address - City:NORFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23505-4600
Mailing Address - Country:US
Mailing Address - Phone:757-889-6633
Mailing Address - Fax:757-489-0913
Practice Address - Street 1:6161 KEMPSVILLE CIR
Practice Address - Street 2:
Practice Address - City:NORFOLK
Practice Address - State:VA
Practice Address - Zip Code:23502-3932
Practice Address - Country:US
Practice Address - Phone:757-889-6633
Practice Address - Fax:757-489-0913
Is Sole Proprietor?:No
Enumeration Date:2005-07-20
Last Update Date:2012-11-19
Deactivation Date:2006-03-20
Deactivation Code:
Reactivation Date:2006-04-06
Provider Licenses
StateLicense IDTaxonomies
VA0101030994207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA006007473Medicaid
VAB10165Medicare UPIN
VA110001316Medicare PIN