Healthcare Provider Details
I. General information
NPI: 1558367268
Provider Name (Legal Business Name): WILLIAM J. MCGROARTY MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 06/27/2005
Last Update Date: 05/07/2015
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2501 KUSER RD SUITE 500
HAMILTON NJ
08691-3386
US
IV. Provider business mailing address
2501 KUSER RD SUITE 500
HAMILTON NJ
08691-3386
US
V. Phone/Fax
- Phone: 609-585-8800
- Fax: 609-585-1825
- Phone: 609-585-8800
- Fax: 609-585-1825
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2085R0202X |
| Taxonomy | Diagnostic Radiology Physician |
| License Number | 25MA04956000 |
| License Number State | NJ |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2085R0202X |
| Taxonomy | Diagnostic Radiology Physician |
| License Number | MD046248L |
| License Number State | PA |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2085B0100X |
| Taxonomy | Body Imaging Physician |
| License Number | MD046248L |
| License Number State | PA |
| # 4 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2085B0100X |
| Taxonomy | Body Imaging Physician |
| License Number | 25MA04956000 |
| License Number State | NJ |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: