Healthcare Provider Details

I. General information

NPI: 1043757982
Provider Name (Legal Business Name): WILLIAM JAMES GARNER M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/31/2017
Last Update Date: 01/31/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 CALLE DEL MUELLE 21007
SAN JUAN PR
00901-2616
US

IV. Provider business mailing address

100 CALLE DEL MUELLE 21007
SAN JUAN PR
00901-2616
US

V. Phone/Fax

Practice location:
  • Phone: 917-653-0470
  • Fax:
Mailing address:
  • Phone: 917-653-0470
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207ZP0101X
TaxonomyAnatomic Pathology Physician
License Number205155
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: