Basic Information
Provider Information
NPI: 1497917942
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: CERRATO
FirstName: WILLIAM
MiddleName: H.
NamePrefix: MR.
NameSuffix:  
Credential: DO
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1113 HEALTHWAY DR
Address2:  
City: SALISBURY
State: MD
PostalCode: 218044470
CountryCode: US
TelephoneNumber: 4103286018
FaxNumber:  
Practice Location
Address1: 100 E CARROLL ST
Address2:  
City: SALISBURY
State: MD
PostalCode: 218015493
CountryCode: US
TelephoneNumber: 8007495191
FaxNumber:  
Other Information
ProviderEnumerationDate: 06/26/2008
LastUpdateDate: 10/23/2018
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
2084P0804XH72194MDY Allopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry

ID Information
IDTypeStateIssuerDescription
259147-00001MDMAGELLAN- ESPS GROUPOTHER
784009301MDAETNA - ESPS GROUPOTHER
34664601MDMHN/TRICARE - ESPS GROUPOTHER
60955000205MD MEDICAID
H7219401MDMEDICAL LICENSEOTHER
R96801MDCAREFIRST - ESPS GROUPOTHER


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