Provider Demographics
NPI:1689765844
Name:MCDONALD, WILLIAM MAFFITT (MD)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:MAFFITT
Last Name:MCDONALD
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 1:1700 NORTHRIDGE ROAD
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30350
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:EMORY DIVISION OF GERIATRIC PSYCHIATRY
Practice Address - Street 2:WESLEY WOODS HEALTH CENTER, 1841 CLIFTON ROAD NE
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30329
Practice Address - Country:US
Practice Address - Phone:404-728-6279
Practice Address - Fax:404-728-6269
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA372922084P0805X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0805XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyGeriatric Psychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA26BDCWNMedicare ID - Type Unspecified
GAC85416001Medicare UPIN