Provider Demographics
NPI:1053364521
Name:OVERSTREET, WILLIAM L III (MD)
Entity type:Individual
Prefix:MR
First Name:WILLIAM
Middle Name:L
Last Name:OVERSTREET
Suffix:III
Gender:M
Credentials:MD
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Mailing Address - Street 1:420 5TH AVE WEST
Mailing Address - Street 2:STE 300
Mailing Address - City:HENDERSONVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28739
Mailing Address - Country:US
Mailing Address - Phone:828-697-3553
Mailing Address - Fax:828-697-5153
Practice Address - Street 1:420 5TH AVE WEST
Practice Address - Street 2:STE 300
Practice Address - City:HENDERSONVILLE
Practice Address - State:NC
Practice Address - Zip Code:28739
Practice Address - Country:US
Practice Address - Phone:828-697-3553
Practice Address - Fax:828-697-5153
Is Sole Proprietor?:No
Enumeration Date:2006-05-18
Last Update Date:2008-03-10
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NCNC9600665208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8964428Medicaid
NC64428OtherBLUE CROSS
G27749Medicare UPIN
NC8964428Medicaid