Provider Demographics
NPI:1467567305
Name:MCWILLIAM, JAMES R (MD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:R
Last Name:MCWILLIAM
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:600 MAMARONECK AVENUE
Mailing Address - Street 2:SUITE 101
Mailing Address - City:MAMARONECK
Mailing Address - State:NY
Mailing Address - Zip Code:10528
Mailing Address - Country:US
Mailing Address - Phone:914-686-0111
Mailing Address - Fax:914-686-8964
Practice Address - Street 1:600 MAMARONECK AVE
Practice Address - Street 2:SUITE 101
Practice Address - City:HARRISON
Practice Address - State:NY
Practice Address - Zip Code:10528-1635
Practice Address - Country:US
Practice Address - Phone:914-686-0111
Practice Address - Fax:914-686-8964
Is Sole Proprietor?:No
Enumeration Date:2006-08-20
Last Update Date:2013-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY233993207XX0004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XX0004XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryFoot and Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02595077Medicaid
HO5742Medicare UPIN
NY602G38J441Medicare PIN
NYA400025908Medicare PIN
NY02595077Medicaid
NY602G373341Medicare PIN