Provider Demographics
NPI:1992787196
Name:DEAL, WILLIAM READ (MD)
Entity type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:READ
Last Name:DEAL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:590 W RIDGE RD
Mailing Address - Street 2:SUITE D
Mailing Address - City:WYTHEVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:24382-1094
Mailing Address - Country:US
Mailing Address - Phone:276-228-7948
Mailing Address - Fax:276-228-7914
Practice Address - Street 1:590 W RIDGE RD
Practice Address - Street 2:SUITE D
Practice Address - City:WYTHEVILLE
Practice Address - State:VA
Practice Address - Zip Code:24382-1094
Practice Address - Country:US
Practice Address - Phone:276-228-7948
Practice Address - Fax:276-228-7914
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-11-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101031896174400000X
GA018010174400000X
SC18193174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA066286OtherANTHEM BLUE CROSS BLUE SH
VA4356625OtherAETNA
VA62411OtherSOUTHERN HEALTH
VA15278OtherPARTNERS
VA2102975OtherMAMSI
VA5788500OtherCIGNA
VA2102975OtherMAMSI