Provider Demographics
NPI:1003807918
Name:FALK, WILLIAM ELLIS (MD)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:ELLIS
Last Name:FALK
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:PO BOX 9142
Mailing Address - Street 2:MASS GENERAL PHYSICIAN ORGANIZATION
Mailing Address - City:CHARLESTOWN
Mailing Address - State:MA
Mailing Address - Zip Code:02129-9142
Mailing Address - Country:US
Mailing Address - Phone:617-724-5600
Mailing Address - Fax:617-726-2000
Practice Address - Street 1:15 PARKMAN ST
Practice Address - Street 2:PSYCHIATRY OUTPATIENT DEPARTMENT WAC 812
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02114-3117
Practice Address - Country:US
Practice Address - Phone:617-726-5600
Practice Address - Fax:617-726-7541
Is Sole Proprietor?:No
Enumeration Date:2005-10-31
Last Update Date:2012-12-18
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA377222084P0800X, 2084P0805X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0805XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyGeriatric Psychiatry
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA037722OtherTUFTS HEALTH PLAN
MA2031574Medicaid
MAC26043OtherBCBS MA
MA037722OtherTUFTS HEALTH PLAN
MAC26043OtherBCBS MA