MEDICARE: DR. WILLIAM ELLIS DONAHUE JR. DPM

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	213ES0103X	Foot & Ankle Surgery Podiatrist	36002283	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	350891	OTHER	OH	STAYWELL HEALTH/WELLCARE
2	000000137360	OTHER	OH	UNICARE
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	000000564755	OTHER	OH	ANTHEM BLUE CROSS BLUE SHIELD
5	000000137360	OTHER	OH	ANTHEM BCBS
6	000000564725	OTHER	OH	ANTHEM BLUE CROSS BLUE SHIELD

General Provider Information

NPI Number	:	1427041565
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. WILLIAM ELLIS DONAHUE JR. DPM

Provider Business Mailing Address
First Line	:	PO BOX 378
Second Line	:
City	:	SANDUSKY
State	:	OH
Zip	:	44871-0378
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1013 ROCKSIDE RD STE B
Second Line	:
City	:	PARMA
State	:	OH
Zip	:	44134-2700
Country	:	US
Telephone Number	:	216-459-8616
Fax Number	:	216-459-0373

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

Provider Enumeration Date	:	08/24/2005
Last Update Date	:	03/16/2018

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