Provider Demographics
NPI:1124014808
Name:MCCANN, WILLIAM P (MD)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:P
Last Name:MCCANN
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 1:354 MERRIMACK ST
Mailing Address - Street 2:
Mailing Address - City:LAWRENCE
Mailing Address - State:MA
Mailing Address - Zip Code:01843-1754
Mailing Address - Country:US
Mailing Address - Phone:978-687-2321
Mailing Address - Fax:978-722-7287
Practice Address - Street 1:354 MERRIMACK ST
Practice Address - Street 2:
Practice Address - City:LAWRENCE
Practice Address - State:MA
Practice Address - Zip Code:01843-1754
Practice Address - Country:US
Practice Address - Phone:978-687-2321
Practice Address - Fax:978-722-7287
Is Sole Proprietor?:No
Enumeration Date:2005-09-27
Last Update Date:2017-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA32368207T00000X
NH4652207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA23593OtherFCHP
MA0035350-001OtherCIGNA
MA06-0001OtherUHC
MA0003742OtherNHP
NH00000121Medicaid
NH0102587Y0MA01OtherANTHEM
MA4474225OtherAETNA
MA715260OtherTHP
MA06-00113OtherEVERCARE
MA2085836Medicaid
MA12410OtherHPHC
MAD13192OtherBCBS
MAD13192Medicare ID - Type UnspecifiedMEDICARE
MA12410OtherHPHC
MA23593OtherFCHP