Provider Demographics
NPI:1417051681
Name:HEBDA, WILLIAM B (MD)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:B
Last Name:HEBDA
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 1:2025 RIVER GROVE LN
Mailing Address - Street 2:
Mailing Address - City:KNIGHTDALE
Mailing Address - State:NC
Mailing Address - Zip Code:27545-8692
Mailing Address - Country:US
Mailing Address - Phone:919-257-8627
Mailing Address - Fax:919-359-9601
Practice Address - Street 1:100 CUNNINGHAM LN
Practice Address - Street 2:
Practice Address - City:CLAYTON
Practice Address - State:NC
Practice Address - Zip Code:27527-3923
Practice Address - Country:US
Practice Address - Phone:919-359-6016
Practice Address - Fax:919-359-6017
Is Sole Proprietor?:No
Enumeration Date:2006-09-11
Last Update Date:2014-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD041724E207Q00000X
NC2008-00624207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA001471751 0002Medicaid
PAHE500658OtherHIGHMARK
PA205258OtherUPMC
PAF49640Medicare UPIN
PAHE500658Medicare ID - Type Unspecified
NC2023399Medicare PIN
PA001471751 0002Medicaid