Provider Demographics
NPI:1265479968
Name:SPECK, WILLIAM T (MD)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:T
Last Name:SPECK
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 1:360 W FALMOUTH HWY
Mailing Address - Street 2:
Mailing Address - City:FALMOUTH
Mailing Address - State:MA
Mailing Address - Zip Code:02540-2027
Mailing Address - Country:US
Mailing Address - Phone:508-289-7690
Mailing Address - Fax:
Practice Address - Street 1:MARINE BIOLOGICAL LABORATORY
Practice Address - Street 2:
Practice Address - City:WOODS HOLE
Practice Address - State:MA
Practice Address - Zip Code:02543
Practice Address - Country:US
Practice Address - Phone:508-289-7690
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-01
Last Update Date:2024-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA51135208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics