Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208200000X | Surgeon | 3444 | ND |
Y | 208600000X | Surgeon | 3444 | ND |
NPI | 1023103421 |
---|---|
Provider Name | William C Elder |
First Address | Hettinger, ND 58639-7533 |
Second Address | Hettinger, ND 58639 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/10/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
10771 | ND BLUECROSS/BLUE SHIELD (01) | ND |
12816 | (05) | ND |
3018140 | (05) | WA |
33265 | SIOUX VALLEY (01) | ND |
7776060 | (05) | SD |
D25851 | (02) |