Individual
DR. VAN WAGNER WILLIAMS III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D. MPH
Contact information
Practice address
16492 MLC LN, ROCKVILLE, VA 23146-1857
(804) 620-3365
(804) 620-3178
Mailing address
16492 MLC LN, ROCKVILLE, VA 23146-1857
(804) 620-3365
(804) 620-3178
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
0101044104
VA
208000000X
Pediatrics Physician
0101044104
VA
208D00000X
General Practice Physician
Primary
0101044104
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0101044104
STATE LICENSE
VA
Enumeration date
06/13/2007
Last updated
09/11/2025
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