Provider Demographics
NPI:1821020306
Name:FAMILY CARE OF WILLIAMSBURG
Entity Type:Organization
Organization Name:FAMILY CARE OF WILLIAMSBURG
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:MONIQUE
Authorized Official - Middle Name:N
Authorized Official - Last Name:SESSLER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:757-565-5440
Mailing Address - Street 1:117 BULIFANTS BLVD
Mailing Address - Street 2:SUITE A
Mailing Address - City:WILLIAMSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:23188-5712
Mailing Address - Country:US
Mailing Address - Phone:757-565-5440
Mailing Address - Fax:757-565-5451
Practice Address - Street 1:117 BULIFANTS BLVD
Practice Address - Street 2:SUITE A
Practice Address - City:WILLIAMSBURG
Practice Address - State:VA
Practice Address - Zip Code:23188-5712
Practice Address - Country:US
Practice Address - Phone:757-565-5440
Practice Address - Fax:757-565-5451
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-07
Last Update Date:2007-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA01049807174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAC08451Medicare PIN