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Contact Information

RUDOLPH E WILLIS, MD
355 CRAWFORD ST
STE 300
PORTSMOUTH, VA23704-2819
 Phone: 757-396-6333
 Fax: 757-396-6367
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Hematology & Oncology

207RH0003X 11 Physician/Internal Medicine
Indicates primary specialty

NPI Profile & details for RUDOLPH E WILLIS · (Male)

NPI # 1831194216
Status Active
Credentials MD
Entity Individual
Enumeration date 06/14/2005
Last updated 07/09/2007 - About 19 years ago
Sole proprietor 1 Not specified
Identifiers
  • VA License # 0101233411
  • NC Other 89067J2 NC MEDICAID
  • VA Other 437204 ANTHEM BCBS
  • VA Other 374935 MAMSI/MDIPA
  • VA Other 59557 OPTIMA HEALTH PLAN
  • VA Other P00013926 RAILROAD MEDICARE
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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