Provider Demographics
NPI:1477545598
Name:MCELMOYLE, WILLIAM E (DO)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:E
Last Name:MCELMOYLE
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:51 SCOTCH RD
Mailing Address - Street 2:
Mailing Address - City:EWING
Mailing Address - State:NJ
Mailing Address - Zip Code:08628-2512
Mailing Address - Country:US
Mailing Address - Phone:609-883-5454
Mailing Address - Fax:609-883-2565
Practice Address - Street 1:51 SCOTCH RD
Practice Address - Street 2:
Practice Address - City:EWING
Practice Address - State:NJ
Practice Address - Zip Code:08628-2512
Practice Address - Country:US
Practice Address - Phone:609-883-5454
Practice Address - Fax:609-883-2565
Is Sole Proprietor?:No
Enumeration Date:2005-08-16
Last Update Date:2024-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS 010838-L207Q00000X
NJ25MB12191200207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1025429860001Medicaid
PA7456385OtherAETNA
PA8767144OtherCIGNA PA
PA2122418000OtherKEYSTONE IBC
PAP00924254OtherRAILROAD MEDICARE
PA1438135OtherHIGHMARK BLUE SHIELD
PA30090226OtherKEYSTONE FIRST
PA2122418000OtherKEYSTONE IBC
PA060879R52Medicare PIN