Provider Demographics
NPI:1578630638
Name:SILL, WILLIAM F (DO)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:F
Last Name:SILL
Suffix:
Gender:M
Credentials:DO
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Mailing Address - Street 1:6 JUNGERMANN CIR
Mailing Address - Street 2:108
Mailing Address - City:SAINT PETERS
Mailing Address - State:MO
Mailing Address - Zip Code:63376-1621
Mailing Address - Country:US
Mailing Address - Phone:636-916-9015
Mailing Address - Fax:639-916-9016
Practice Address - Street 1:6 JUNGERMANN CIR
Practice Address - Street 2:108
Practice Address - City:SAINT PETERS
Practice Address - State:MO
Practice Address - Zip Code:63376-1621
Practice Address - Country:US
Practice Address - Phone:636-916-9015
Practice Address - Fax:639-916-9016
Is Sole Proprietor?:No
Enumeration Date:2006-11-30
Last Update Date:2007-07-08
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Provider Licenses
StateLicense IDTaxonomies
MO32792207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
A10544Medicare UPIN