Provider Demographics
NPI:1194700484
Name:HUNDLEY, WILLIAM GREGORY (MD)
Entity type:Individual
Prefix:
First Name:WILLIAM
Middle Name:GREGORY
Last Name:HUNDLEY
Suffix:
Gender:M
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:PO BOX 91734
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23291-1734
Mailing Address - Country:US
Mailing Address - Phone:804-358-6100
Mailing Address - Fax:804-342-7619
Practice Address - Street 1:417 N 11TH ST
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23298-5002
Practice Address - Country:US
Practice Address - Phone:804-628-4327
Practice Address - Fax:804-828-4670
Is Sole Proprietor?:No
Enumeration Date:2005-12-09
Last Update Date:2018-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101264892207RC0000X
NC96 01344207RM1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207RM1200XAllopathic & Osteopathic PhysiciansInternal MedicineMagnetic Resonance Imaging (MRI)
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC16230OtherPARTNERS
WV6020047000Medicaid
NC66503OtherMEDCOST
NC8944597Medicaid
SCQ01344Medicaid
NC44597OtherBCBS
NC7062360OtherAETNA
VA5808898Medicaid
NC66503OtherMEDCOST
NC16230OtherPARTNERS
NC7062360OtherAETNA
NC60067684Medicare PIN