Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RN0300X | Nephrologist | 45388 | MN |
NPI | 1053398032 |
---|---|
Provider Name | William Stuart |
First Address | Minneapolis, MN 55425-4516 |
Second Address | St Louis Park, MN 55426-5000 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/12/2005 |
Last Update Date | 28/04/2016 |