Provider Demographics
NPI:1588924633
Name:WILLIAMS, ALBERT WAYNE (MD)
Entity type:Individual
Prefix:DR
First Name:ALBERT
Middle Name:WAYNE
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 1:42995 ELK PL
Mailing Address - Street 2:
Mailing Address - City:CHANTILLY
Mailing Address - State:VA
Mailing Address - Zip Code:20152-5900
Mailing Address - Country:US
Mailing Address - Phone:703-327-7330
Mailing Address - Fax:
Practice Address - Street 1:42995 ELK PL
Practice Address - Street 2:
Practice Address - City:CHANTILLY
Practice Address - State:VA
Practice Address - Zip Code:20152-5900
Practice Address - Country:US
Practice Address - Phone:703-327-7330
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-23
Last Update Date:2012-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101245524202C00000X, 207ZF0201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZF0201XAllopathic & Osteopathic PhysiciansPathologyForensic Pathology
No202C00000XAllopathic & Osteopathic PhysiciansIndependent Medical Examiner