Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208G00000X | Cardiothoracic Vascular Surgeon | 4557 | ND |
NPI | 1043310964 |
---|---|
Provider Name | Dr. Edward Williams |
First Address | Bismarck, ND 58501-4516 |
Second Address | Bismarck, ND 58501-4516 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/09/2006 |
Last Update Date | 03/03/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1043310964 | NPI (01) | |
P00208171 | RAILROAD MEDICARE (01) | ND |