Provider Demographics
NPI:1497716849
Name:WARE, WILLIAM CHARLES (MD)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:CHARLES
Last Name:WARE
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 1:2901 DUTTON MILL RD STE 110
Mailing Address - Street 2:
Mailing Address - City:ASTON
Mailing Address - State:PA
Mailing Address - Zip Code:19014-2850
Mailing Address - Country:US
Mailing Address - Phone:610-485-6700
Mailing Address - Fax:610-485-9540
Practice Address - Street 1:2901 DUTTON MILL RD STE 110
Practice Address - Street 2:
Practice Address - City:ASTON
Practice Address - State:PA
Practice Address - Zip Code:19014
Practice Address - Country:US
Practice Address - Phone:610-485-6700
Practice Address - Fax:610-485-9540
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-28
Last Update Date:2018-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD029812E207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1007230Medicaid
PADT0827OtherRAILROAD MEDICARE
PA147695OtherHIGHMARK BS
147695Medicare PIN
PA147695OtherHIGHMARK BS