Provider Demographics
NPI:1841221793
Name:SEVERT, WILLIAM L (MD)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:L
Last Name:SEVERT
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:PO BOX 95000-2445
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19195-0001
Mailing Address - Country:US
Mailing Address - Phone:212-844-6734
Mailing Address - Fax:212-844-6437
Practice Address - Street 1:10 UNION SQ E
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10003-3314
Practice Address - Country:US
Practice Address - Phone:212-844-8379
Practice Address - Fax:212-844-8461
Is Sole Proprietor?:No
Enumeration Date:2006-07-06
Last Update Date:2014-06-06
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Provider Licenses
StateLicense IDTaxonomies
NY23347312084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYWS05213V20Medicare PIN