Provider Demographics
NPI:1124108592
Name:WAY, DENISE A (MD)
Entity type:Individual
Prefix:
First Name:DENISE
Middle Name:A
Last Name:WAY
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:145 EDNAM DR STE 214
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTESVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:22903-4625
Mailing Address - Country:US
Mailing Address - Phone:434-226-7899
Mailing Address - Fax:434-732-7116
Practice Address - Street 1:145 EDNAM DR STE 214
Practice Address - Street 2:
Practice Address - City:CHARLOTTESVILLE
Practice Address - State:VA
Practice Address - Zip Code:22903-4625
Practice Address - Country:US
Practice Address - Phone:434-226-7899
Practice Address - Fax:434-732-7116
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-17
Last Update Date:2023-09-26
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
VA0101240542207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1124108592Medicaid
VA1124108592Medicaid