William Calvin Dundore Jr., M.D.

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

License

MD019412E Issued in PA

Practice address

647 North Broad Street Ext
Wolf Creek Medical Associates
Grove City, PA 16127-4604

Phone

(724) 458-7737

Fax

(724) 458-7388

NPI assigned

May 31, 2005

Last updated

May 21, 2010By the provider in NPPES

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1117497600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1274400000000",
    "number": "1083617476",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "647 NORTH BROAD STREET EXT",
            "address_2": "WOLF CREEK MEDICAL ASSOCIATES",
            "city": "GROVE CITY",
            "state": "PA",
            "postal_code": "161274604",
            "telephone_number": "724-458-7737",
            "fax_number": "724-458-7388"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "647 NORTH BROAD STREET EXT",
            "address_2": "WOLF CREEK MEDICAL ASSOCIATES",
            "city": "GROVE CITY",
            "state": "PA",
            "postal_code": "161274604",
            "telephone_number": "724-458-7737",
            "fax_number": "724-458-7388"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUNDORE",
        "first_name": "WILLIAM",
        "middle_name": "CALVIN",
        "name_suffix": "Jr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-05-31",
        "last_updated": "2010-05-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "PA",
            "license": "MD019412E",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0006580860003",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Obstetrics & Gynecology Physician in Grove City, PA
• Providers in Grove City, PA by specialty
• Obstetrics & Gynecology Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.