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Individual
DR. WILLIE B MAGDAMO JR.
Active
Individual
DR. WILLIE B MAGDAMO JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
2008-00972
NC
207Q00000X
Family Medicine Physician
4301081798
MI
207Q00000X
Family Medicine Physician
Primary
P0993
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
300697501
—
TX
05
—
300697502
—
TX
05
—
4920898
—
MI
05
—
4920904
—
MI
05
—
4920913
—
MI
05
—
5909872
—
NC
Enumeration date
08/09/2006
Last updated
04/16/2013
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