Basic Information
| Provider Information | |||||||||
| NPI: | 1952391831 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | VANCISE | ||||||||
| FirstName: | WILLIAM | ||||||||
| MiddleName: | S. | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 936 | ||||||||
| Address2: | EVMS HEALTH SERVICES | ||||||||
| City: | NORFOLK | ||||||||
| State: | VA | ||||||||
| PostalCode: | 235010936 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7573883483 | ||||||||
| FaxNumber: | 7576270334 | ||||||||
| Practice Location | |||||||||
| Address1: | 2390 ENTERPRISE ST | ||||||||
| Address2: | |||||||||
| City: | FREMONT | ||||||||
| State: | OH | ||||||||
| PostalCode: | 434208507 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4195592700 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/24/2005 | ||||||||
| LastUpdateDate: | 05/20/2020 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 05/20/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2085R0001X | 0101251598 | VA | N | Allopathic & Osteopathic Physicians | Radiology | Radiation Oncology | 2085R0001X | 35.125388 | OH | Y | Allopathic & Osteopathic Physicians | Radiology | Radiation Oncology |
ID Information
| ID | Type | State | Issuer | Description | 457165 | 01 | VA | ANTHEM BC/BS | OTHER | PAR | 01 | VA | VIRGINIA HEALTH NETWORK | OTHER | PAR | 01 | VA | MULTIPLAN | OTHER | 1952391831 | 01 | VA | UNITED HEALTHCARE | OTHER | 1952391831 | 01 | VA | FIRST HEALTH COMMERCIAL/COVENTRY HEALTH | OTHER | 1952391831 | 05 | VA | MEDICAID | PAR | 01 | VA | CIGNA | OTHER | PAR | 01 | VA | USA MANAGED CARE | OTHER | 5919914 | 05 | NC | MEDICAID | 10091624 | 01 | VA | OPTIMA HEALTH | OTHER | 1952391831 | 01 | VA | TRICARE | OTHER | PAR | 01 | VA | CORVEL | OTHER | PAR | 01 | VA | AETNA | OTHER |