Provider Demographics
NPI:1659388502
Name:MAXTED, WILLIAM C JR (MD)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:C
Last Name:MAXTED
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:106 IRVING ST NW
Mailing Address - Street 2:STE 2700N
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20010-2927
Mailing Address - Country:US
Mailing Address - Phone:202-723-5524
Mailing Address - Fax:202-291-0512
Practice Address - Street 1:2002 MEDICAL PKWY
Practice Address - Street 2:STE 500
Practice Address - City:ANNAPOLIS
Practice Address - State:MD
Practice Address - Zip Code:21401-3046
Practice Address - Country:US
Practice Address - Phone:410-573-6480
Practice Address - Fax:410-573-9413
Is Sole Proprietor?:No
Enumeration Date:2006-08-02
Last Update Date:2008-04-01
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Provider Licenses
StateLicense IDTaxonomies
MDD56322207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD066M895EMedicare PIN
MDF62098Medicare PIN
MD066MMedicare PIN
DC409629Medicare PIN
DC007467C29Medicare PIN
MDCD0361Medicare PIN