# DIGESTIVE ENDOSCOPY, PA

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1144588773
- **Authorized official:** MR. WILLIAM CHARLES DUANE JR. MD (PRESIDENT)
- **Authorized official phone:** (763) 416-0399

## Contact information

- **Practice address:** 17322 91ST AVE N, MAPLE GROVE, MN 55311-5403
- **Practice address phone:** (763) 416-0399
- **Practice address fax:** (763) 416-0399
- **Mailing address:** 5970 ARBOUR AVE, EDINA, MN 55436-2521
- **Mailing address phone:** (952) 920-6638
- **Mailing address fax:** (612) 725-2248

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207RG0100X | Gastroenterology Physician | 19698 | MN | Yes |

## Other

- **Enumeration date:** 05/02/2012
- **Last updated:** 05/02/2012

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 1033127964 | NPI 1 | MN |
| 05 | — | 255716900 | — | MN |