Provider Demographics
NPI:1265616221
Name:FIRST MED OF WILLIAMSBURG
Entity type:Organization
Organization Name:FIRST MED OF WILLIAMSBURG
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:A
Authorized Official - Last Name:CAMPANA
Authorized Official - Suffix:SR
Authorized Official - Credentials:MD
Authorized Official - Phone:757-229-4141
Mailing Address - Street 1:312 SECOND STREET
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:23185
Mailing Address - Country:US
Mailing Address - Phone:757-229-4141
Mailing Address - Fax:757-229-1792
Practice Address - Street 1:312 SECOND STREET
Practice Address - Street 2:
Practice Address - City:WILLIAMSBURG
Practice Address - State:VA
Practice Address - Zip Code:23185
Practice Address - Country:US
Practice Address - Phone:757-229-4141
Practice Address - Fax:757-229-1792
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-26
Last Update Date:2007-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101051684VA207Q00000X
VA0101035546207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty