Provider Demographics
NPI:1174791859
Name:MCGLOTHLIN, WILLIAM GEORGE (MD)
Entity type:Individual
Prefix:
First Name:WILLIAM
Middle Name:GEORGE
Last Name:MCGLOTHLIN
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 1:8421 DORSEY CIRCLE
Mailing Address - Street 2:SUITE 102
Mailing Address - City:MANASSAS
Mailing Address - State:VA
Mailing Address - Zip Code:20110
Mailing Address - Country:US
Mailing Address - Phone:703-368-1683
Mailing Address - Fax:703-365-2306
Practice Address - Street 1:8421 DORSEY CIRCLE
Practice Address - Street 2:SUITE 102
Practice Address - City:MANASSAS
Practice Address - State:VA
Practice Address - Zip Code:20110
Practice Address - Country:US
Practice Address - Phone:703-368-1683
Practice Address - Fax:703-365-2306
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-14
Last Update Date:2008-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA01010514992084P0800X, 2084P0804X
WI303182084P0800X, 2084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry