Doctor Name: | STEVEN STENBERG WILLIAMSON |
NPI Number: | 1588898035 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | PAC |
License Number: | 2473-23 |
Business Practice Address: | 5803 Neal Ave N Oak Park Heights, MN - 550822177 |
Business Phone Number: | 6514398807 |
Business Fax Number: | 6514390232 |
Mailing Address: | 5803 Neal Ave N, OAK PARK HEIGHTS |
State: | MN |
Postal Code: | 550822177 |
Phone Number: | 6514398807 |
Fax Number: | 6514390232 |
NPI Enumeration Date: | 05/13/2009 |
NPI Last Update Date: | 06/30/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363AS0400X |
License Number: | 2473-23 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | WI |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Physician Assistant |
Taxonomy Specialization: | Surgical |
Taxonomy Definition: |