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NPI Code Detail

MEDICARE: WILLIAM LEWIS VANDUZER PA

MEDICARE: WILLIAM LEWIS VANDUZER PA
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
1207P00000XEmergency Medicine PhysicianMA001700LPA
2363AM0700XMedical Physician Assistant004581NY
3363AM0700XMedical Physician AssistantMA001700LPA

General Provider Information

NPI Number : 1750380960
Entity Type Code : Individual
Provider Name (Legal Business Name) : WILLIAM LEWIS VANDUZER PA
Provider Business Mailing Address
First Line : 4372 ROUTE 6
Second Line :
City : KANE
State : PA
Zip : 16735-3060
Country : US
Telephone Number : 814-837-4560
Fax Number : 814-837-7905
Provider Business Practice Location Address
First Line : 4372 ROUTE 6
Second Line :
City : KANE
State : PA
Zip : 16735-3060
Country : US
Telephone Number : 814-837-4560
Fax Number : 814-837-7905
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/19/2005
Last Update Date : 07/06/2022

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Directions to “ WILLIAM LEWIS VANDUZER PA” Practice Location

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