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Individual

DR. WILLIAM J. MCAVENEY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
221 RANDOLPH ST, MINERAL, VA 23117-4493
(540) 872-2638
Mailing address
10623 CRESTWOOD DR, MANASSAS, VA 20109-3433

Taxonomy

Speciality
Code
Description
License number
State
2080A0000X
Pediatric Adolescent Medicine Physician
Primary
0101030932
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0101030932
MEDICAL LICENSE
VA
Enumeration date
01/04/2007
Last updated
07/08/2007
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