Dr. Sean Thomas Willey
Sports Medicine
8100 W 78th St Suite 230
Edina
, Minnesota 55439-2516
Dr. Sean Thomas Willey
Sports Medicine
8100 W 78th St Suite 230
Edina
, Minnesota 55439-2516
(612) 262-5000
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About
Features
Specialties
- Sports Medicine
Languages spoken
- English
Location
First Address
- Dr. Sean Thomas Willey
- 2925 Chicago Ave
- Minneapolis, MN
- Zip : 55407-1321
- Phone : (612) 262-5000
Second Address
- Dr. Sean Thomas Willey
- 8100 W 78th St Suite 230
- Edina, MN
- Zip : 55439-2516
- Phone : (952) 946-9777
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 2081S0010X | Sports Medicine | 54642 | MN |
| Y | 213ES0000X | Sports Medicine | 54642 | MN |
National Provider Identifier
| NPI | 1346335684 |
|---|---|
| Provider Name | Dr. Sean Thomas Willey |
| First Address | Minneapolis, MN 55407-1321 |
| Second Address | Edina, MN 55439-2516 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 03/10/2006 |
| Last Update Date | 02/03/2021 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 250001056 | MEDICARE PTAN (01) | MN |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.