Provider Demographics
NPI:1841291564
Name:BEHRENS, WILLIAM EDWARD (MD)
Entity type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:EDWARD
Last Name:BEHRENS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:1111 BENFIELD BLVD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:MILLERSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21108-3002
Mailing Address - Country:US
Mailing Address - Phone:410-729-5100
Mailing Address - Fax:443-679-1382
Practice Address - Street 1:129 LUBRANO DR
Practice Address - Street 2:SUITE 100
Practice Address - City:ANNAPOLIS
Practice Address - State:MD
Practice Address - Zip Code:21401-7566
Practice Address - Country:US
Practice Address - Phone:410-266-5852
Practice Address - Fax:410-266-5095
Is Sole Proprietor?:No
Enumeration Date:2005-08-03
Last Update Date:2014-03-25
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MDD0036488207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD235472OtherMAMSI SPECIALIST
MD7605-0025OtherCAREFIRST BLUECHOICE
MD400813-02OtherCAREFIRST MD RENDERING
MD4417726OtherAETNA FEE FOR SERVICE
MD2938726OtherCIGNA PIN
MD835472OtherMAMSI PRIMARY CARE
MD011380OtherJHHC PROVIDER NUMBER
MD285081800Medicaid
MD80083142OtherRAILROAD MEDICARE
MDP11959OtherCAREFIRST MPOS
MD235472OtherMAMSI SPECIALIST
MD2938726OtherCIGNA PIN
MD285081800Medicaid