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Individual

DANA RAY WILLIAMS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PA-C

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
101941
NC
363AM0700X
Medical Physician Assistant
Primary
0110840307
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1063485001
VA
01
P00603322
MEDICARE RAILROAD
VA
Enumeration date
02/09/2006
Last updated
09/21/2016
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