Provider Demographics
NPI:1912903139
Name:PRECHEL, WILLIAM P (DO)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:P
Last Name:PRECHEL
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1735 GOLFVIEW DR
Mailing Address - Street 2:
Mailing Address - City:DEARBORN
Mailing Address - State:MI
Mailing Address - Zip Code:48128-1443
Mailing Address - Country:US
Mailing Address - Phone:313-584-3624
Mailing Address - Fax:
Practice Address - Street 1:16551 W WARREN AVE
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48228-3706
Practice Address - Country:US
Practice Address - Phone:313-584-3624
Practice Address - Fax:313-584-8060
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-22
Last Update Date:2016-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5101006899207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI5821071OtherBLUE CROSS BLUE SHIELD MI
MI1294700Medicaid
MI5821071OtherBLUE CROSS BLUE SHIELD MI
MI1294700Medicaid