Provider Demographics
NPI:1689656373
Name:DILLON, WILLIAM D (MD)
Entity Type:Individual
Prefix:MR
First Name:WILLIAM
Middle Name:D
Last Name:DILLON
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 1:844 FRANKLIN ST
Mailing Address - Street 2:UNIT 2
Mailing Address - City:WRENTHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02093-1223
Mailing Address - Country:US
Mailing Address - Phone:508-384-5000
Mailing Address - Fax:508-384-6124
Practice Address - Street 1:844 FRANKLIN ST
Practice Address - Street 2:4
Practice Address - City:WRENTHAM
Practice Address - State:MA
Practice Address - Zip Code:02093-1223
Practice Address - Country:US
Practice Address - Phone:508-384-2500
Practice Address - Fax:508-384-9410
Is Sole Proprietor?:No
Enumeration Date:2005-11-17
Last Update Date:2019-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA50050207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA3010449Medicaid
D88416Medicare UPIN
MAJ05369Medicare ID - Type Unspecified