Provider Demographics
NPI:1104990019
Name:LITTERER, WILLIAM EDWARD III (DO)
Entity type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:EDWARD
Last Name:LITTERER
Suffix:III
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:360 GIFFORD ST
Mailing Address - Street 2:UNIT 2
Mailing Address - City:FALMOUTH
Mailing Address - State:MA
Mailing Address - Zip Code:02540-2912
Mailing Address - Country:US
Mailing Address - Phone:508-457-0215
Mailing Address - Fax:
Practice Address - Street 1:360 GIFFORD ST
Practice Address - Street 2:UNIT 2
Practice Address - City:FALMOUTH
Practice Address - State:MA
Practice Address - Zip Code:02540-2912
Practice Address - Country:US
Practice Address - Phone:508-457-0215
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-20
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA72177207RG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA3056970Medicaid
J09274Medicare ID - Type UnspecifiedMEDICARE
MA3056970Medicaid