Individual
WILLIAM B MCILVAINE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4800 ALBERTA AVE, EL PASO, TX 79905-2709
(915) 215-5625
(915) 545-6984
Mailing address
4800 ALBERTA AVE, EL PASO, TX 79905-2709
(915) 215-5625
(915) 545-6984
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
G43753
CA
207LP3000X
Pediatric Anesthesiology Physician
Primary
N8124
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00G437530
—
CA
01
—
00G437530 F91
CAL OPTIMA
CA
Enumeration date
09/20/2006
Last updated
02/20/2014
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