Provider Demographics
NPI:1336222017
Name:COVELL, WILLIAM (MD)
Entity type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:
Last Name:COVELL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:212 CARTER DR
Mailing Address - Street 2:SUITE A
Mailing Address - City:MIDDLETOWN
Mailing Address - State:DE
Mailing Address - Zip Code:19709-5837
Mailing Address - Country:US
Mailing Address - Phone:302-376-9058
Mailing Address - Fax:
Practice Address - Street 1:212 CARTER DR
Practice Address - Street 2:SUITE A
Practice Address - City:MIDDLETOWN
Practice Address - State:DE
Practice Address - Zip Code:19709-5837
Practice Address - Country:US
Practice Address - Phone:302-378-4407
Practice Address - Fax:302-378-4610
Is Sole Proprietor?:No
Enumeration Date:2006-10-24
Last Update Date:2015-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEC10005656207R00000X
MDD0054584207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE0000943001Medicaid
DEP00035301OtherRAILROAD MEDICARE
H02910Medicare UPIN
DEP00035301OtherRAILROAD MEDICARE