Provider Demographics
NPI:1265526578
Name:CIESLA, WILLIAM P JR (MD)
Entity type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:P
Last Name:CIESLA
Suffix:JR
Gender:M
Credentials:MD
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Mailing Address - Street 1:8266 ATLEE RD
Mailing Address - Street 2:MOB #2, SUITE 319
Mailing Address - City:MECHANICSVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:23116-1804
Mailing Address - Country:US
Mailing Address - Phone:804-764-7965
Mailing Address - Fax:804-764-7969
Practice Address - Street 1:8266 ATLEE RD
Practice Address - Street 2:MOB #2, SUITE 319
Practice Address - City:MECHANICSVILLE
Practice Address - State:VA
Practice Address - Zip Code:23116-1804
Practice Address - Country:US
Practice Address - Phone:804-764-7965
Practice Address - Fax:804-764-7969
Is Sole Proprietor?:No
Enumeration Date:2006-10-03
Last Update Date:2007-08-27
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Provider Licenses
StateLicense IDTaxonomies
VA0101054991207R00000X, 207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
09109M84Medicare ID - Type Unspecified
H28242Medicare UPIN