William Bryan Icenhower , MPH
General Practice • Leonardtown, MD
Notice of NPI Deactivation & Inactive Practice Status
According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, William Icenhower has officially deactivated this NPI record and ceased active healthcare practice.
Professional Overview & Biography Verified Profile Summary
William Icenhower, MPH was a registered General Practice practicing in Leonardtown, MD. Throughout an active medical career spanning 13 years, William Icenhower provided care at the practice location at 21580 PEABODY ST until profile deactivation on 2021-06-17.
Practice Location & Contact Primary Location
21580 Peabody St
Leonardtown, MD 206502962
Specialty Benchmarks & Practice Insights
Comparative analytics for General Practice in Leonardtown, MD
Practicing in Leonardtown, MD (421 Statewide)
In-Person Office Visits Only
Under CMS Medicare Fee Schedule vs Standard Submitted Charges
Medical Specialties & State Licenses
NUCC Taxonomy Code: 208D00000X
A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions.
Practice Associates & Co-Workers
Healthcare professionals and specialists practicing at this location or sharing practice phone/fax
Nurse Practitioner - Family
Family Nurse Practitioner (Board Certified)
Career & Practice History Timeline
Chronological log of verified NPI updates, location relocations, credentials, and registry changes
Record deactivated on June 17, 2021
NPI status registered as active in NPPES database
Registered at 21580 PEABODY ST, LEONARDTOWN, MD 206502962 (Tel: 3014754317)
Registered at 21580 PEABODY ST, P.O. BOX 316, LEONARDTOWN, MD 206500316 (Tel: 3014754317)
Recorded as WILLIAM ICENHOWER, MPH
General Practice (License #D0050093 in MD)
First registered as active Individual Practitioner in NPPES Database.
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NPI Administrative Meta
Mailing Address
21580 Peabody St, P.o. Box 316
Leonardtown, MD 206500316
Phone: 3014754317
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