Provider Demographics
NPI:1548289796
Name:WARDELL, ARTHUR W (MD)
Entity type:Individual
Prefix:
First Name:ARTHUR
Middle Name:W
Last Name:WARDELL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:5818 D HARBOUR VIEW BLVD
Mailing Address - Street 2:STE 150
Mailing Address - City:SUFFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23435-3315
Mailing Address - Country:US
Mailing Address - Phone:757-215-1400
Mailing Address - Fax:757-215-1403
Practice Address - Street 1:5818 D HARBOUR VIEW BLVD
Practice Address - Street 2:STE 150
Practice Address - City:SUFFOLK
Practice Address - State:VA
Practice Address - Zip Code:23435-3315
Practice Address - Country:US
Practice Address - Phone:757-215-1400
Practice Address - Fax:757-215-1403
Is Sole Proprietor?:No
Enumeration Date:2006-07-19
Last Update Date:2020-04-27
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VA010103201207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA010080533Medicaid
VAB09977Medicare UPIN
VAP00100491Medicare ID - Type UnspecifiedRAILROAD