Provider Demographics
NPI:1073575312
Name:BIRTWHISTLE, WILLIAM H (MD)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:H
Last Name:BIRTWHISTLE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12791 CABEZUT RD
Mailing Address - Street 2:
Mailing Address - City:SONORA
Mailing Address - State:CA
Mailing Address - Zip Code:95370-5926
Mailing Address - Country:US
Mailing Address - Phone:209-532-5524
Mailing Address - Fax:209-532-1518
Practice Address - Street 1:12791 CABEZUT RD
Practice Address - Street 2:
Practice Address - City:SONORA
Practice Address - State:CA
Practice Address - Zip Code:95370-5926
Practice Address - Country:US
Practice Address - Phone:209-532-5524
Practice Address - Fax:209-532-1518
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAG27815208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics