Provider Demographics
NPI:1295704716
Name:WILLIAMS, SCOTT S (MD)
Entity type:Individual
Prefix:
First Name:SCOTT
Middle Name:S
Last Name:WILLIAMS
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:PO BOX 936
Mailing Address - Street 2:
Mailing Address - City:NORFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23501-0936
Mailing Address - Country:US
Mailing Address - Phone:757-388-3483
Mailing Address - Fax:757-627-0334
Practice Address - Street 1:600 GRESHAM DR
Practice Address - Street 2:
Practice Address - City:NORFOLK
Practice Address - State:VA
Practice Address - Zip Code:23507-1904
Practice Address - Country:US
Practice Address - Phone:757-388-3483
Practice Address - Fax:757-627-0334
Is Sole Proprietor?:No
Enumeration Date:2006-03-16
Last Update Date:2015-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA01012312662085R0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAPAROtherCORVEL/CORCARE
VAPAROtherAETNA
VAPAROtherUSA MANAGED CARE
VA188994OtherANTHEM
VAPAROtherVIRGINIA HEALTH NETWORK
VAPAROtherFIRST HEALTH COMMERCIAL/SOUTHERN HEALTH/COVENTRY
NC133XFOtherNC BC/BS
NC89133XFMedicaid
VAPAROtherVIRGINIA PREMIER HEALTH
VAPAROtherTRICARE/CHAMPUS
VA41490OtherSENTARA
VA191851OtherANTHEM
2144525OtherUHC/MAMSI
VAPAROtherCIGNA
VA010246075Medicaid
VAPAROtherUSA MANAGED CARE
VAPAROtherVIRGINIA HEALTH NETWORK
VAPAROtherAETNA