Provider Demographics
NPI:1154323525
Name:UNDERDOWN, WILLIAM E (MD)
Entity type:Individual
Prefix:
First Name:WILLIAM
Middle Name:E
Last Name:UNDERDOWN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:2520 CHERRY AVE
Mailing Address - Street 2:HARRISON MEDICAL CENTER
Mailing Address - City:BREMERTON
Mailing Address - State:WA
Mailing Address - Zip Code:98310
Mailing Address - Country:US
Mailing Address - Phone:360-792-6610
Mailing Address - Fax:360-744-6188
Practice Address - Street 1:450 SO. KITSAP BLVD.
Practice Address - Street 2:SUITE 100
Practice Address - City:PORT ORCHARD
Practice Address - State:WA
Practice Address - Zip Code:98366
Practice Address - Country:US
Practice Address - Phone:360-744-6275
Practice Address - Fax:360-744-6188
Is Sole Proprietor?:No
Enumeration Date:2005-08-15
Last Update Date:2009-04-02
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
WAMD00023348207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA911703412OtherTRICARE
WA314823001OtherGROUP HEALTH
WA8927800OtherCRIME VICTIMS
08001412OtherRAILROAD MEDICARE
WA1095850Medicaid
WAUN0601OtherREGENCE
WA104922OtherL & I
WA91170341201OtherKPS
WAUN0601OtherREGENCE
WA911703412OtherTRICARE