Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207V00000X | Obstetrician & Gynecologist | 34770 | MN |
N | 207VG0400X | Gynecologist | 34770 | MN |
Y | 207VX0201X | Gynecologic Oncologist | 34770 | MN |
NPI | 1205815636 |
---|---|
Provider Name | William A Cliby |
First Address | Rochester, MN 55905-0001 |
Second Address | Rochester, MN 55905-0001 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/01/2006 |
Last Update Date | 12/08/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
F45047 | (02) |