Provider Demographics
NPI:1457344053
Name:FERMAN, WILLIAM B (MD)
Entity type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:B
Last Name:FERMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1310 BERTHA AVE
Mailing Address - Street 2:SUITE A
Mailing Address - City:BREMERTON
Mailing Address - State:WA
Mailing Address - Zip Code:98312-2607
Mailing Address - Country:US
Mailing Address - Phone:360-373-0200
Mailing Address - Fax:360-373-0425
Practice Address - Street 1:1310 BERTHA AVE
Practice Address - Street 2:SUITE A
Practice Address - City:BREMERTON
Practice Address - State:WA
Practice Address - Zip Code:98312-2607
Practice Address - Country:US
Practice Address - Phone:360-373-0200
Practice Address - Fax:360-373-0425
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-30
Last Update Date:2008-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD 00026366207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA7067655Medicaid
WA8869776OtherMEDICARE GROUP IDENTIFIER
WA8869777OtherMEDICARE INDIVIDUAL IDENT
WA7067655Medicaid