Basic Information
| Provider Information | |||||||||
| NPI: | 1790779494 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | SIMS | ||||||||
| FirstName: | WILLIAM | ||||||||
| MiddleName: | ROBERT | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1200 BROOKS LN | ||||||||
| Address2: | STE 180 | ||||||||
| City: | JEFFERSON HILLS | ||||||||
| State: | PA | ||||||||
| PostalCode: | 150253747 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4124693600 | ||||||||
| FaxNumber: | 4124693630 | ||||||||
| Practice Location | |||||||||
| Address1: | 1200 BROOKS LN | ||||||||
| Address2: | STE 180 | ||||||||
| City: | JEFFERSON HILLS | ||||||||
| State: | PA | ||||||||
| PostalCode: | 150253747 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4124693600 | ||||||||
| FaxNumber: | 4124693630 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/08/2005 | ||||||||
| LastUpdateDate: | 04/12/2018 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RS0012X | MD044208E | PA | N | Allopathic & Osteopathic Physicians | Internal Medicine | Sleep Medicine | 207RP1001X | MD044208E | PA | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Pulmonary Disease | 207RC0200X | MD044208E | PA | N | Allopathic & Osteopathic Physicians | Internal Medicine | Critical Care Medicine |
ID Information
| ID | Type | State | Issuer | Description | 001169532 | 05 | PA | MEDICAID |