Provider Demographics
NPI:1669414736
Name:MCCADIE, WILLIAM THOMAS JR (DO)
Entity type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:THOMAS
Last Name:MCCADIE
Suffix:JR
Gender:M
Credentials:DO
Other - Prefix:
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Mailing Address - Street 1:2935 E IRON WOODS PASS
Mailing Address - Street 2:
Mailing Address - City:MIDLAND
Mailing Address - State:MI
Mailing Address - Zip Code:48642-7962
Mailing Address - Country:US
Mailing Address - Phone:262-366-3408
Mailing Address - Fax:
Practice Address - Street 1:4000 WELLNESS DR.
Practice Address - Street 2:MID MICHIGAN HEALTH
Practice Address - City:MIDLAND
Practice Address - State:MI
Practice Address - Zip Code:48670
Practice Address - Country:US
Practice Address - Phone:989-839-1644
Practice Address - Fax:989-839-3029
Is Sole Proprietor?:No
Enumeration Date:2006-06-12
Last Update Date:2019-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5101015721207R00000X, 208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1668414736Medicaid
MI1538397120OtherGROUP NPI LAKELAND MEDICAL PRACTICES
WI43532600Medicaid
WIB43168Medicare UPIN
WI003168280Medicare PIN