Provider Demographics
NPI:1164487419
Name:MACLAUGHLIN, WILLIAM WITTMER (MD)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:WITTMER
Last Name:MACLAUGHLIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:856 J CLYDE MORRIS BLVD
Mailing Address - Street 2:SUITE A
Mailing Address - City:NEWPORT NEWS
Mailing Address - State:VA
Mailing Address - Zip Code:23601-1318
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:110 WIMBLEDON SQ
Practice Address - Street 2:SUITE E
Practice Address - City:CHESAPEAKE
Practice Address - State:VA
Practice Address - Zip Code:23320
Practice Address - Country:US
Practice Address - Phone:757-436-2995
Practice Address - Fax:757-436-2912
Is Sole Proprietor?:No
Enumeration Date:2006-04-19
Last Update Date:2014-01-27
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VA0101034996207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1164487419Medicaid
VA014385P80Medicare PIN
B85825Medicare UPIN
VAP00462164Medicare PIN