Provider Demographics
NPI:1528030145
Name:LYNDERS, WILLIAM T (MD)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:T
Last Name:LYNDERS
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:28 CRESCENT ST
Mailing Address - Street 2:EMERGENCY ROOM/MIDDLESEX HOSPITAL
Mailing Address - City:MIDDLETOWN
Mailing Address - State:CT
Mailing Address - Zip Code:06457-3654
Mailing Address - Country:US
Mailing Address - Phone:860-358-8016
Mailing Address - Fax:860-358-8010
Practice Address - Street 1:28 CRESCENT ST
Practice Address - Street 2:EMERGENCY ROOM/MIDDLESEX HOSPITAL
Practice Address - City:MIDDLETOWN
Practice Address - State:CT
Practice Address - Zip Code:06457-3654
Practice Address - Country:US
Practice Address - Phone:860-358-8016
Practice Address - Fax:860-358-8010
Is Sole Proprietor?:No
Enumeration Date:2006-02-07
Last Update Date:2014-10-20
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CT032268207P00000X
CT32268207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CTF41367Medicare UPIN