Individual
DR. HERBERT ALEXANDER WILSON III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
704 THIMBLE SHOALS BLVD, BLDG 300A, NEWPORT NEWS, VA 23606
(757) 595-4300
(757) 591-9297
Mailing address
860 OMNI BLVD, SUITE 303, NEWPORT NEWS, VA 23606-4430
(757) 232-8777
(757) 232-8866
Taxonomy
Speciality
Code
Description
License number
State
207RR0500X
Rheumatology Physician
Primary
0101041638
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
068804
ANTHEM
VA
01
—
C04725
GROUP PTAN
—
Enumeration date
10/11/2006
Last updated
03/13/2012
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