Organization
GREATER SUFFOLK MEDICAL CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MICHAEL T WILLIAMS MD (PRESIDENT)
(757) 934-1003
Entity
Organization
Contact information
Practice address
114 N MAIN ST STE 200, SUFFOLK, VA 23434-4564
(757) 934-1003
(757) 934-1660
Mailing address
114 N MAIN ST STE 200, SUFFOLK, VA 23434-4564
(757) 934-1003
(757) 934-1660
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
0101033710
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
041021
BLUE CROSS
VA
01
—
095436
BLUE CROSS
VA
05
—
110007205
—
VA
01
—
12068
OPTIMA
VA
01
—
12104
OPTIMA
VA
01
—
13762
OPTIMA
VA
01
—
45055
OPTIMA
VA
05
—
5813735
—
VI
05
—
6068286
—
VI
05
—
7360720
—
NC
05
—
77906536
—
NC
05
—
7906203
—
NC
05
—
890658E
—
NC
Enumeration date
02/06/2007
Last updated
04/28/2010
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