Individual
DR. WILLIAM W IDE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1204 W MAIN ST, CHARLOTTESVILLE, VA 22903-2824
(434) 924-5161
Mailing address
PO BOX 9007, CHARLOTTESVILLE, VA 22906-9007
(434) 295-1000
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
0101248009
VA
2081P0010X
Pediatric Rehabilitation Medicine Physician
Primary
0101248009
VA
2081P0010X
Pediatric Rehabilitation Medicine Physician
D0091395
MD
Other
Enumeration date
06/16/2009
Last updated
07/09/2024
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