Provider Demographics
NPI:1568444164
Name:CARTMILL, WILLIAM C (MD)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:C
Last Name:CARTMILL
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 1:451 HEALTH PKWY
Mailing Address - Street 2:SUITE E
Mailing Address - City:PAW PAW
Mailing Address - State:MI
Mailing Address - Zip Code:49079-8242
Mailing Address - Country:US
Mailing Address - Phone:269-655-3090
Mailing Address - Fax:269-655-0763
Practice Address - Street 1:451 HEALTH PKWY
Practice Address - Street 2:SUITE E
Practice Address - City:PAW PAW
Practice Address - State:MI
Practice Address - Zip Code:49079-8242
Practice Address - Country:US
Practice Address - Phone:269-655-3090
Practice Address - Fax:269-655-0763
Is Sole Proprietor?:No
Enumeration Date:2005-11-18
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301049170208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI238601OtherMEDICARE RURAL HEALTH CLINIC NUMBER
MI4938453Medicaid
MIM20520056Medicare PIN
MI238601OtherMEDICARE RURAL HEALTH CLINIC NUMBER