Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RG0300X | Geriatric Medicine | 72177 | MA |
NPI | 1104990019 |
---|---|
Provider Name | Dr. William Edward Litterer III |
First Address | Falmouth, MA 02540-2912 |
Second Address | Falmouth, MA 02540-2912 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 20/11/2006 |
Last Update Date | 09/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
3056970 | (05) | MA |
C57716 | (02) |