Provider Demographics
NPI:1326220104
Name:WILLIAM C. DALY MD LLC
Entity Type:Organization
Organization Name:WILLIAM C. DALY MD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:CHARLES
Authorized Official - Last Name:DALY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:207-833-3250
Mailing Address - Street 1:396 MOUNTAIN RD
Mailing Address - Street 2:
Mailing Address - City:HARPSWELL
Mailing Address - State:ME
Mailing Address - Zip Code:04079-2218
Mailing Address - Country:US
Mailing Address - Phone:207-833-3250
Mailing Address - Fax:
Practice Address - Street 1:396 MOUNTAIN RD
Practice Address - Street 2:
Practice Address - City:HARPSWELL
Practice Address - State:ME
Practice Address - Zip Code:04079-2218
Practice Address - Country:US
Practice Address - Phone:207-833-3250
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-03
Last Update Date:2014-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEMD19580207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA709813OtherTUFTS HEALTH PLAN
MAAA2379OtherHARVARD PILGRIM HEALTH CA
MAD24022OtherBLUE CROSS BLUESHIELD