Provider Demographics
NPI:1952391831
Name:VANCISE, WILLIAM S (MD)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:S
Last Name:VANCISE
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:EVMS HEALTH SERVICES
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 1:2390 ENTERPRISE ST
Practice Address - Street 2:
Practice Address - City:FREMONT
Practice Address - State:OH
Practice Address - Zip Code:43420-8507
Practice Address - Country:US
Practice Address - Phone:419-559-2700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-10-24
Last Update Date:2020-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA01012515982085R0001X
OH35.1253882085R0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA457165OtherANTHEM BC/BS
VAPAROtherVIRGINIA HEALTH NETWORK
VAPAROtherMULTIPLAN
VA1952391831OtherUNITED HEALTHCARE
VA1952391831OtherFIRST HEALTH COMMERCIAL/COVENTRY HEALTH
VA1952391831Medicaid
VAPAROtherCIGNA
VAPAROtherUSA MANAGED CARE
NC5919914Medicaid
VA10091624OtherOPTIMA HEALTH
VA1952391831OtherTRICARE
VAPAROtherCORVEL
VAPAROtherAETNA
VA457165OtherANTHEM BC/BS
D31083Medicare UPIN