Healthcare Provider Details

I. General information

NPI: 1467071209
Provider Name (Legal Business Name): WILLIAM SIDELINGER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/12/2020
Last Update Date: 06/16/2025
Certification Date: 06/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

309 BELMONT ST
WORCESTER MA
01604-1059
US

IV. Provider business mailing address

1601 23RD AVENUE SOUTH TRAINING OFFICE SUITE 3105 VPH
NASHVILLE TN
37212
US

V. Phone/Fax

Practice location:
  • Phone: 508-368-3300
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License Number1023236
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: