1033238647 NPI number — DR. WILLIAM WALLACE ASHLEY JR. M.D., PH.D., M.B.A.

Table of content: DR. WILLIAM WALLACE ASHLEY JR. M.D., PH.D., M.B.A. (NPI 1033238647)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1033238647 NPI number — DR. WILLIAM WALLACE ASHLEY JR. M.D., PH.D., M.B.A.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ASHLEY
Provider First Name:
WILLIAM
Provider Middle Name:
WALLACE
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
JR.
Provider Credential Text:
M.D., PH.D., M.B.A.
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1033238647
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
11/11/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
5051 GREENSPRING AVE
Provider Second Line Business Mailing Address:
SUITE 300
Provider Business Mailing Address City Name:
BALTIMORE
Provider Business Mailing Address State Name:
MD
Provider Business Mailing Address Postal Code:
21209-4354
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
410-601-4417
Provider Business Mailing Address Fax Number:
410-601-7138

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
5051 GREENSPRING AVE
Provider Second Line Business Practice Location Address:
SUITE 300
Provider Business Practice Location Address City Name:
BALTIMORE
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
21209-4354
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
410-601-4417
Provider Business Practice Location Address Fax Number:
410-601-7138
Provider Enumeration Date:
03/28/2007

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207T00000X , with the licence number:  D82113 , registered in the state of MD ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 520486540 . This is a "EMPLOYER TAX ID" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".




Copyright © 2007-2024 www.npivalidator.com