Provider Demographics
NPI:1619927670
Name:COBB, WILLIAM E (MD)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:E
Last Name:COBB
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:100 HIGHLAND - STREET STE 209
Mailing Address - Street 2:
Mailing Address - City:MILTON
Mailing Address - State:MA
Mailing Address - Zip Code:02186
Mailing Address - Country:US
Mailing Address - Phone:617-698-8184
Mailing Address - Fax:617-698-6918
Practice Address - Street 1:100 HIGHLAND STREET, STE 209
Practice Address - Street 2:
Practice Address - City:MILTON
Practice Address - State:MA
Practice Address - Zip Code:02186
Practice Address - Country:US
Practice Address - Phone:617-698-8184
Practice Address - Fax:617-698-6918
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-11
Last Update Date:2012-08-28
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MA042468207R00000X, 207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA2063468Medicaid
MA2063468Medicaid
C90637Medicare UPIN