Provider Demographics
NPI:1033116827
Name:PEASE, WILLIAM S (MD)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:S
Last Name:PEASE
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:700 ACKERMAN RD STE 2120
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43202-1559
Mailing Address - Country:US
Mailing Address - Phone:614-293-2594
Mailing Address - Fax:614-293-4487
Practice Address - Street 1:480 MEDICAL CENTER DR
Practice Address - Street 2:ROOM 1018
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43210-1245
Practice Address - Country:US
Practice Address - Phone:614-293-7604
Practice Address - Fax:614-293-3809
Is Sole Proprietor?:No
Enumeration Date:2005-07-07
Last Update Date:2020-12-28
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
OH35-047148208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0555402Medicaid
OH0555402Medicaid
PE0550273Medicare PIN