Individual
PRESCOTT WADE PRILLAMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
7611 FOREST AVE, SUITE 330, RICHMOND, VA 23229-4946
(804) 673-8791
(804) 673-3226
Mailing address
7611 FOREST AVE, SUITE 330, RICHMOND, VA 23229-4946
(804) 673-8791
(804) 673-3226
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
0101056025
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
006201849
—
VA
05
—
1578510780
—
VA
01
—
160050950
MEDICARE RR
—
01
—
217097
ANTHEM
VA
Enumeration date
05/31/2006
Last updated
02/10/2022
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