Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207K00000X | Allergist & Immunologist | 14750 | WV |
N | 207K00000X | Allergist & Immunologist | 2005-00679 | NC |
N | 207K00000X | Allergist & Immunologist | MD437096 | PA |
NPI | 1154306850 |
---|---|
Provider Name | Dr. William Thomas Corder |
First Address | Clarksburg, WV 26301-2665 |
Second Address | Morgantown, WV 26508-8847 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/12/2005 |
Last Update Date | 23/01/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
001171808 | (05) | PA |
0071544000 | (05) | WV |
5901036 | (05) | NC |
E54317 | (02) | NC |
E54317 | (02) | WV |