Provider Demographics
NPI:1467460949
Name:REGENOLD, WILLIAM THOMAS (MD)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:THOMAS
Last Name:REGENOLD
Suffix:
Gender:M
Credentials:MD
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:10 CENTER DR
Mailing Address - Street 2:NIH CLINICAL CENTER ROOM 7-3343
Mailing Address - City:BETHESDA
Mailing Address - State:MD
Mailing Address - Zip Code:20892-4515
Mailing Address - Country:US
Mailing Address - Phone:301-793-4897
Mailing Address - Fax:410-328-5882
Practice Address - Street 1:10 CENTER DRIVE
Practice Address - Street 2:NIH CLINICAL CENTER ROOM 7-3343
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20892-1023
Practice Address - Country:US
Practice Address - Phone:301-793-4897
Practice Address - Fax:410-328-5882
Is Sole Proprietor?:No
Enumeration Date:2006-08-03
Last Update Date:2023-07-25
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MDD00411712084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD180041800Medicaid
MDF94728Medicare UPIN