Provider Demographics
NPI:1679567424
Name:KANTER, WILLIAM RALPH (MD)
Entity type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:RALPH
Last Name:KANTER
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 1:5092 DORSEY HALL DR
Mailing Address - Street 2:SUITE 102
Mailing Address - City:ELLICOTT CITY
Mailing Address - State:MD
Mailing Address - Zip Code:21042-7711
Mailing Address - Country:US
Mailing Address - Phone:410-715-9205
Mailing Address - Fax:
Practice Address - Street 1:5092 DORSEY HALL DR
Practice Address - Street 2:SUITE 102
Practice Address - City:ELLICOTT CITY
Practice Address - State:MD
Practice Address - Zip Code:21042-7711
Practice Address - Country:US
Practice Address - Phone:410-715-9205
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-09-08
Last Update Date:2010-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD 36913208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD1404676OtherCIGNA
MD49376OtherUNITED HEALTH CARE
MDC532WROtherMARYLAND BC/BS
MDP00067639OtherMEDICARE RR
MD4140451OtherAETNA
MD426083 01OtherBLUELINE RENDERING
MD5348 0002OtherFEDERAL BC
MD326BMedicare ID - Type Unspecified
MD4140451OtherAETNA