Provider Demographics
NPI:1053369454
Name:WILLIAMS, ANDREA ELLEN (MD)
Entity type:Individual
Prefix:MS
First Name:ANDREA
Middle Name:ELLEN
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:700 S WASHINGTON ST STE 330
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22314-4252
Mailing Address - Country:US
Mailing Address - Phone:703-940-3364
Mailing Address - Fax:703-717-4055
Practice Address - Street 1:700 S WASHINGTON ST STE 330
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:VA
Practice Address - Zip Code:22314-4252
Practice Address - Country:US
Practice Address - Phone:703-940-3364
Practice Address - Fax:703-717-4055
Is Sole Proprietor?:No
Enumeration Date:2006-05-05
Last Update Date:2021-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA010105190207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAC10894Medicare UPIN
VA391345ZAEMedicare PIN
VA00K79W50Medicare ID - Type Unspecified