Provider Demographics
NPI:1174534911
Name:DOLAN, WILLIAM A (MD)
Entity type:Individual
Prefix:
First Name:WILLIAM
Middle Name:A
Last Name:DOLAN
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 1:880 WESTFALL RD
Mailing Address - Street 2:STE A
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14618-2611
Mailing Address - Country:US
Mailing Address - Phone:585-546-8140
Mailing Address - Fax:585-473-5864
Practice Address - Street 1:880 WESTFALL RD
Practice Address - Street 2:STE A
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14618-2611
Practice Address - Country:US
Practice Address - Phone:585-546-8140
Practice Address - Fax:585-473-5864
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-10
Last Update Date:2012-01-24
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY107414207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYP010107414OtherBLUE CHOICE
NY100604CUOtherPREFERRED CARE
5873341OtherAETNA
NY00470053Medicaid
0500693OtherGHI
NY0186OtherBCBS- ROCHESTER, NY
7701958OtherMVP
B72071Medicare UPIN
0500693OtherGHI