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NPI Code Detail

MEDICARE: MR. WILLIAM HOWARD LORDEN PA-C

MEDICARE: MR. WILLIAM HOWARD LORDEN PA-C
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363A00000XPhysician Assistant5601005082MI

General Provider Information

NPI Number : 1114113073
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. WILLIAM HOWARD LORDEN PA-C
Provider Business Mailing Address
First Line : 1420 WILDWOOD ST
Second Line :
City : MIDLAND
State : MI
Zip : 48642-7116
Country : US
Telephone Number : 989-631-7054
Fax Number :
Provider Business Practice Location Address
First Line : 690 S TRUMBULL ST
Second Line :
City : BAY CITY
State : MI
Zip : 48708-7692
Country : US
Telephone Number : 989-922-4911
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/24/2007
Last Update Date : 09/24/2007

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Directions to “ MR. WILLIAM HOWARD LORDEN PA-C” Practice Location

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