Basic Information
Provider Information
NPI: 1477657799
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: HUNTER
FirstName: WILLIAM
MiddleName: L
NamePrefix: DR.
NameSuffix: JR.
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 3100 WYMAN PARK DRIVE
Address2: SUITE 359A
City: BALTIMORE
State: MD
PostalCode: 21211
CountryCode: US
TelephoneNumber: 4103383016
FaxNumber: 4103383420
Practice Location
Address1: 1132 ANNAPOLIS ROAD
Address2:  
City: ODENTON
State: MD
PostalCode: 21113
CountryCode: US
TelephoneNumber: 4108741400
FaxNumber: 4108741411
Other Information
ProviderEnumerationDate: 09/08/2006
LastUpdateDate: 07/08/2007
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207Q00000XD43789MDY Allopathic & Osteopathic PhysiciansFamily Medicine 

No ID Information.


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