Provider Demographics
NPI:1538108055
Name:DUFFY, WILLIAM N (MD)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:N
Last Name:DUFFY
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 1:1001 CHESTERBROOK BLVD
Mailing Address - Street 2:3RD FL
Mailing Address - City:BERWYN
Mailing Address - State:PA
Mailing Address - Zip Code:19312
Mailing Address - Country:US
Mailing Address - Phone:610-576-7515
Mailing Address - Fax:610-576-7546
Practice Address - Street 1:1001 CHESTERBROOK BLVD FL 3
Practice Address - Street 2:
Practice Address - City:BERWYN
Practice Address - State:PA
Practice Address - Zip Code:19312-3805
Practice Address - Country:US
Practice Address - Phone:610-576-7515
Practice Address - Fax:610-576-7546
Is Sole Proprietor?:No
Enumeration Date:2006-06-06
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD060436L207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0016035740009Medicaid
PA0016035740009Medicaid
PA437004Medicare PIN