Provider Demographics
NPI:1851681316
Name:WILLIAMS, GWENDOLYN ROWENA (MD)
Entity Type:Individual
Prefix:MS
First Name:GWENDOLYN
Middle Name:ROWENA
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 1:4000 COLISEUM DR STE 445
Mailing Address - Street 2:
Mailing Address - City:HAMPTON
Mailing Address - State:VA
Mailing Address - Zip Code:23666-5981
Mailing Address - Country:US
Mailing Address - Phone:757-827-2127
Mailing Address - Fax:757-827-2255
Practice Address - Street 1:4000 COLISEUM DR STE 445
Practice Address - Street 2:
Practice Address - City:HAMPTON
Practice Address - State:VA
Practice Address - Zip Code:23666
Practice Address - Country:US
Practice Address - Phone:757-827-2127
Practice Address - Fax:757-827-2255
Is Sole Proprietor?:No
Enumeration Date:2011-04-18
Last Update Date:2019-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101258075208M00000X, 207R00000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program