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Individual

DR. WILLIAM T. CORRELL

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.O.

Contact information

Practice address
1919 LAKE AVE STE 106, PLYMOUTH, IN 46563-7830
(574) 335-5220
(574) 335-0859
Mailing address
5215 HOLY CROSS PKWY, MISHAWAKA, IN 46545-1469
(574) 335-8707
(574) 335-0074

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
5101014163DO
MI
207Q00000X
Family Medicine Physician
Primary
02007492A
IN
207Q00000X
Family Medicine Physician
5101014163
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
080D410020
BDBSM COM BLUE
MI
01
1022813
MHP HAN INDIVIDUAL
MI
01
1022851
MHP HAN GROUP
MI
05
300082849
IN
05
4849166
MI
05
4849184
MI
05
4849193
MI
05
4963714
MI
Enumeration date
05/10/2006
Last updated
01/13/2026
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