Healthcare Provider Details

I. General information

NPI: 1376725820
Provider Name (Legal Business Name): WILLIAM J. PIERCE,M.D.,P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/27/2007
Last Update Date: 02/19/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

210 E 90TH DR
MERRILLVILLE IN
46410-8102
US

IV. Provider business mailing address

210 E 90TH DR
MERRILLVILLE IN
46410-8102
US

V. Phone/Fax

Practice location:
  • Phone: 219-738-2008
  • Fax: 219-738-2127
Mailing address:
  • Phone: 219-738-2008
  • Fax: 219-738-2127

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number StateIN

VIII. Authorized Official

Name: DR. WILLIAM JOHN PIERCE
Title or Position: PRESIDENT
Credential: M.D.
Phone: 219-738-2008