Willis, Rudolph E

Willis, Rudolph E is an individual health care provider with primary practice located at 355 Crawford St Ste 300, Portsmouth VA 23704-2819. He recently has only one registered license in Allopathic & Osteopathic Physicians / Hematology & Oncology, which is considered as his primary health care specialty. Willis, Rudolph E can be contacted via phone (757) 396-6333.

Contact Information

Primary practice address
355 Crawford St Ste 300 Portsmouth VA 23704-2819
Phone: (757) 396-6333
Fax: (757) 396-6367
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Hematology & Oncology 207RH0003X 0101233411 Virginia

Profile Details

NPI number 1831194216
LBN Legal business name Willis, Rudolph E
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 14th, 2005
Last updated Jul 9th, 2007 - about 18 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1831194216 NPPES
North Carolina Other 89067J2 NC MEDICAID
North Carolina Other P00013926 NC MEDICAID
North Carolina Other 437204 NC MEDICAID
North Carolina Other 59557 NC MEDICAID
North Carolina Other 374935 NC MEDICAID

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