Provider Demographics
NPI:1093746612
Name:CATTELL, WILLIAM STUART (MD)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:STUART
Last Name:CATTELL
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:PO BOX 8837
Mailing Address - Street 2:
Mailing Address - City:CAMP HILL
Mailing Address - State:PA
Mailing Address - Zip Code:17001-8837
Mailing Address - Country:US
Mailing Address - Phone:717-737-4531
Mailing Address - Fax:
Practice Address - Street 1:144 5TH AVE
Practice Address - Street 2:
Practice Address - City:HYNDMAN
Practice Address - State:PA
Practice Address - Zip Code:15545-7379
Practice Address - Country:US
Practice Address - Phone:814-842-3206
Practice Address - Fax:814-842-1969
Is Sole Proprietor?:No
Enumeration Date:2006-07-05
Last Update Date:2023-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY200848207Q00000X
PAMD-060377-L207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01702363Medicaid
E97059Medicare UPIN
NY01702363Medicaid