Healthcare Provider Details

I. General information

NPI: 1295719433
Provider Name (Legal Business Name): WILLIAM FRANKLIN WINECOFF III M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 12/01/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6825 16TH ST NW
WASHINGTON DC
20306-0003
US

IV. Provider business mailing address

14416 ASHLEIGH GREENE RD
BOYDS MD
20841-4377
US

V. Phone/Fax

Practice location:
  • Phone: 202-782-2762
  • Fax: 202-782-3056
Mailing address:
  • Phone: 301-972-9463
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207ZP0102X
TaxonomyAnatomic Pathology & Clinical Pathology Physician
License Number18975
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: