Provider Demographics
NPI:1780646091
Name:MENDE, WILLIAM R (MD)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:R
Last Name:MENDE
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:118 WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:HARRISBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17104-1677
Mailing Address - Country:US
Mailing Address - Phone:717-231-8539
Mailing Address - Fax:717-231-8588
Practice Address - Street 1:1000 EVELYN DR
Practice Address - Street 2:
Practice Address - City:MILLERSBURG
Practice Address - State:PA
Practice Address - Zip Code:17061-1258
Practice Address - Country:US
Practice Address - Phone:717-692-4761
Practice Address - Fax:717-692-2381
Is Sole Proprietor?:No
Enumeration Date:2006-04-03
Last Update Date:2008-05-05
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Provider Licenses
StateLicense IDTaxonomies
PAMD019670E207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAC29629Medicare UPIN