Provider Demographics
NPI:1114127669
Name:WILLIAM, JACQUELINE MAY-LOUISE (MD , PHD)
Entity type:Individual
Prefix:DR
First Name:JACQUELINE
Middle Name:MAY-LOUISE
Last Name:WILLIAM
Suffix:
Gender:F
Credentials:MD , PHD
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Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:332 JAMAICAWAY APT 306
Mailing Address - Street 2:
Mailing Address - City:JAMAICA PLAIN
Mailing Address - State:MA
Mailing Address - Zip Code:02130-4343
Mailing Address - Country:US
Mailing Address - Phone:617-522-4074
Mailing Address - Fax:
Practice Address - Street 1:75 FRANCIS ST
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02115-6110
Practice Address - Country:US
Practice Address - Phone:617-732-8613
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-07-23
Last Update Date:2007-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA222153207ZP0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0101XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology