Provider Demographics
NPI:1194754564
Name:WILLIAMS, CHARLES PIERRE (MD)
Entity type:Individual
Prefix:DR
First Name:CHARLES
Middle Name:PIERRE
Last Name:WILLIAMS
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 1:5838 HARBOUR VIEW BLVD
Mailing Address - Street 2:SUITE 240
Mailing Address - City:SUFFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23435-2663
Mailing Address - Country:US
Mailing Address - Phone:757-483-3030
Mailing Address - Fax:
Practice Address - Street 1:5838 HARBOUR VIEW BLVD
Practice Address - Street 2:SUITE 240
Practice Address - City:SUFFOLK
Practice Address - State:VA
Practice Address - Zip Code:23435-2663
Practice Address - Country:US
Practice Address - Phone:757-483-3030
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-30
Last Update Date:2017-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101239990208600000X
PAMD441529208600000X
NC2009-00497208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA247101OtherBCBS
VA010286883Medicaid
VA010588F73Medicare PIN
VA010588F73Medicare PIN
VA247101OtherBCBS
VA010286883Medicaid
PAP00981375Medicare PIN
PA2066932OtherHIGHMARK BLUE SHIELD-WMG
PA416567OtherUPMC-WMG
PA1594028OtherGATEWAY-WMG
PA30088135OtherAMERIHEALTH MERCY-WMG