Provider Demographics
NPI:1689410813
Name:WILLIAMS GENTLE, TENDAI (MBBS)
Entity type:Individual
Prefix:
First Name:TENDAI
Middle Name:
Last Name:WILLIAMS GENTLE
Suffix:
Gender:F
Credentials:MBBS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:GRADUATE MEDICAL EDUCATION
Mailing Address - Street 2:PO BOX 1980
Mailing Address - City:NORFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23501
Mailing Address - Country:US
Mailing Address - Phone:757-446-6190
Mailing Address - Fax:
Practice Address - Street 1:GRADUATE MEDICAL EDUCATION
Practice Address - Street 2:PO BOX 1980
Practice Address - City:NORFOLK
Practice Address - State:VA
Practice Address - Zip Code:23501
Practice Address - Country:US
Practice Address - Phone:757-446-6190
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-08
Last Update Date:2024-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program