Provider Demographics
NPI:1346278561
Name:DRIEHORST, WILLIAM L (MD)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:L
Last Name:DRIEHORST
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:5255 E STOP 11 RD
Mailing Address - Street 2:SUITE 250
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46237-6340
Mailing Address - Country:US
Mailing Address - Phone:317-865-5737
Mailing Address - Fax:317-865-5780
Practice Address - Street 1:5255 E STOP 11 RD
Practice Address - Street 2:SUITE 250
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46237-6340
Practice Address - Country:US
Practice Address - Phone:317-865-5737
Practice Address - Fax:317-865-5780
Is Sole Proprietor?:No
Enumeration Date:2006-06-28
Last Update Date:2008-05-21
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
IN01037796A207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
189990Medicare PIN
INA80885Medicare UPIN