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General NPI Number Information
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NPI Number | 1225086994
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Entity Type | Individual
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Provider Name | WILLIAM E MACDONNELL P.A.
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Gender | Male
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Dates
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Enumeration Date | 05/05/2006
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Last Update Date | 03/13/2023
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Provider Practice Location Address
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Address Line | 1501 W MOUNT ROYAL AVE
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City | BALTIMORE
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State | MD
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Zip | 21217-4289
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Country | US
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Telephone | 410-225-4118
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Fax | 410-225-0252
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Provider Business Mailing Address
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Address Line | 3500 BOSTON ST STE J1
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City | BALTIMORE
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State | MD
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Zip | 21224-5723
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Country | US
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Telephone | 410-522-0001
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Fax | 410-522-0017
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | C0002492
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License Number State | MD
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