Provider Demographics
NPI:1689679268
Name:INGRAM, WILLIAM C (MD)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:C
Last Name:INGRAM
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Gender:M
Credentials:MD
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Mailing Address - Street 1:21 HIGHLAND AVE STE 2
Mailing Address - Street 2:SUITE 2
Mailing Address - City:NEWBURYPORT
Mailing Address - State:MA
Mailing Address - Zip Code:01950-3873
Mailing Address - Country:US
Mailing Address - Phone:978-463-7770
Mailing Address - Fax:978-462-0220
Practice Address - Street 1:21 HIGHLAND AVE STE 2
Practice Address - Street 2:SUITE 2
Practice Address - City:NEWBURYPORT
Practice Address - State:MA
Practice Address - Zip Code:01950-3873
Practice Address - Country:US
Practice Address - Phone:978-463-7770
Practice Address - Fax:978-462-0220
Is Sole Proprietor?:No
Enumeration Date:2005-06-20
Last Update Date:2016-12-15
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Provider Licenses
StateLicense IDTaxonomies
MA41054207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA27-2777455OtherTAX ID