Provider Demographics
NPI:1700947389
Name:DALY, WILLIAM CHARLES (MD)
Entity type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:CHARLES
Last Name:DALY
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 1:396 MOUNTAIN RD
Mailing Address - Street 2:
Mailing Address - City:HARPSWELL
Mailing Address - State:ME
Mailing Address - Zip Code:04079-2218
Mailing Address - Country:US
Mailing Address - Phone:207-833-3250
Mailing Address - Fax:
Practice Address - Street 1:396 MOUNTAIN RD
Practice Address - Street 2:
Practice Address - City:HARPSWELL
Practice Address - State:ME
Practice Address - Zip Code:04079-2218
Practice Address - Country:US
Practice Address - Phone:207-833-3250
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-13
Last Update Date:2014-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA44037207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA628704OtherBCBS ANTHEM
MAD24022OtherBLUE CROSS BLUE SHIELD
MA709813OtherTUFTS HEALTH PLAN
MAAA2379OtherHARVARD PILGRIM HEALTH CA
MAB10332401OtherCIGNA HEALTH CARE
MA110202146OtherRR MEDICARE
MA82930OtherHEALTHSOURCE
D24022Medicare ID - Type Unspecified
MA82930OtherHEALTHSOURCE