Provider Demographics
NPI:1184718314
Name:PIERCE, WILLIAM C (MD)
Entity type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:C
Last Name:PIERCE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:875 OAK ST SE
Mailing Address - Street 2:SUITE 4030
Mailing Address - City:SALEM
Mailing Address - State:OR
Mailing Address - Zip Code:97301-3975
Mailing Address - Country:US
Mailing Address - Phone:503-561-6444
Mailing Address - Fax:503-561-6440
Practice Address - Street 1:875 OAK ST SE
Practice Address - Street 2:SUITE 4030
Practice Address - City:SALEM
Practice Address - State:OR
Practice Address - Zip Code:97301-3975
Practice Address - Country:US
Practice Address - Phone:503-561-6444
Practice Address - Fax:503-561-6440
Is Sole Proprietor?:No
Enumeration Date:2006-10-03
Last Update Date:2021-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
ORMD 18627207RH0003X
OKMD18627207RH0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
No207RH0000XAllopathic & Osteopathic PhysiciansInternal MedicineHematology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR061325Medicaid
ORR107056Medicare ID - Type UnspecifiedSALEM MEDICARE #
ORE92226Medicare UPIN
ORR107058Medicare ID - Type UnspecifiedMCMINNVILLE MEDICARE #