Provider Demographics
NPI:1851528988
Name:IDE, WILLIAM WARREN (MD)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:WARREN
Last Name:IDE
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:KENNEDY KRIEGER INSTITUTE
Mailing Address - Street 2:707 NORTH BROADWAY
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21205-4311
Mailing Address - Country:US
Mailing Address - Phone:443-994-2485
Mailing Address - Fax:
Practice Address - Street 1:KENNEDY KRIEGER INSTITUTE
Practice Address - Street 2:707 NORTH BROADWAY
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21205-2120
Practice Address - Country:US
Practice Address - Phone:443-923-9440
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-06-16
Last Update Date:2022-01-16
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Provider Licenses
StateLicense IDTaxonomies
MDD00913952081P0010X, 2081P0010X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2081P0010XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPediatric Rehabilitation Medicine