Provider Demographics
NPI:1386764538
Name:EXHEM-WILLIAMS, CYNTHIA (PA-C)
Entity type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:
Last Name:EXHEM-WILLIAMS
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:116 CARRIAGE COURT LN
Mailing Address - Street 2:
Mailing Address - City:CONCORD
Mailing Address - State:VA
Mailing Address - Zip Code:24538-3145
Mailing Address - Country:US
Mailing Address - Phone:804-919-4411
Mailing Address - Fax:804-309-4114
Practice Address - Street 1:116 CARRIAGE COURT LN
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:VA
Practice Address - Zip Code:24538-3145
Practice Address - Country:US
Practice Address - Phone:804-919-4411
Practice Address - Fax:804-309-4114
Is Sole Proprietor?:No
Enumeration Date:2007-03-30
Last Update Date:2016-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0110840435363A00000X
NY003484-1363A00000X, 363AM0700X
363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant