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General NPI Number Information
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NPI Number | 1154306850
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Entity Type | Individual
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Provider Name | WILLIAM THOMAS CORDER MD
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Gender | Male
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Dates
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Enumeration Date | 12/14/2005
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Last Update Date | 01/23/2015
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Provider Practice Location Address
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Address Line | 165 SCOTT AVE SUITE 102
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City | MORGANTOWN
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State | WV
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Zip | 26508-8847
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Country | US
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Telephone | 304-554-0440
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Fax | 304-624-0026
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Provider Business Mailing Address
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Address Line | 125 N 6TH ST
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City | CLARKSBURG
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State | WV
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Zip | 26301-2665
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Country | US
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Telephone | 304-624-7200
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Fax | 304-624-0026
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207K00000X
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Taxonomy Name | Allergy & Immunology Physician
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License Number | 2005-00679
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 207K00000X
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Taxonomy Name | Allergy & Immunology Physician
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License Number | 14750
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License Number State | WV
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Taxonomy #3
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Taxonomy Code | 207K00000X
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Taxonomy Name | Allergy & Immunology Physician
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License Number | MD437096
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License Number State | PA
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