Provider Demographics
NPI:1770529547
Name:MAYHALL, WILLIAM ST (MD)
Entity type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:ST
Last Name:MAYHALL
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:70 TRAFALGAR DR
Mailing Address - Street 2:
Mailing Address - City:PORT TOWNSEND
Mailing Address - State:WA
Mailing Address - Zip Code:98368-2517
Mailing Address - Country:US
Mailing Address - Phone:360-379-2731
Mailing Address - Fax:360-379-3988
Practice Address - Street 1:1280 CENTER ST NE
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:OR
Practice Address - Zip Code:97301-4113
Practice Address - Country:US
Practice Address - Phone:503-581-4402
Practice Address - Fax:503-581-8817
Is Sole Proprietor?:No
Enumeration Date:2006-06-21
Last Update Date:2007-07-09
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
OR9214207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
ORC93249Medicare UPIN