MEDICARE: WILLIAM L. MEDFORD MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207YX0007X	Plastic Surgery within the Head & Neck (Otolaryngology) Physician	C10000637	DE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1003851718
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	WILLIAM L. MEDFORD MD

Provider Business Mailing Address
First Line	:	2300 PENNSYLVANIA AVE
Second Line	:	SUITE 2A
City	:	WILMINGTON
State	:	DE
Zip	:	19806-1392
Country	:	US
Telephone Number	:	302-658-0404
Fax Number	:

Provider Business Practice Location Address
First Line	:	2300 PENNSYLVANIA AVE
Second Line	:	SUITE 2A
City	:	WILMINGTON
State	:	DE
Zip	:	19806-1392
Country	:	US
Telephone Number	:	302-658-0404
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/17/2006
Last Update Date	:	09/03/2008

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