Provider Demographics
NPI:1386696607
Name:YOUNG, WINFIELD ANTHONY (MD)
Entity type:Individual
Prefix:DR
First Name:WINFIELD
Middle Name:ANTHONY
Last Name:YOUNG
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:1212 LAKE JAMES DR
Mailing Address - Street 2:STE C
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23464-6779
Mailing Address - Country:US
Mailing Address - Phone:757-523-4589
Mailing Address - Fax:757-523-8920
Practice Address - Street 1:1212 LAKE JAMES DR
Practice Address - Street 2:STE C
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23464-6779
Practice Address - Country:US
Practice Address - Phone:757-523-4589
Practice Address - Fax:757-523-8920
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-16
Last Update Date:2012-09-12
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Provider Licenses
StateLicense IDTaxonomies
VA0101040247208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA006710646Medicaid
VA006710646Medicaid