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Individual

DR. DAVID ALLEN WILLEY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1200 CHASKA CREEK WAY, SUITE 200, CHASKA, MN 55318-2152
(952) 448-3303
(952) 448-4409
Mailing address
1200 CHASKA CREEK WAY, SUITE 200, CHASKA, MN 55318
(952) 856-1046
(952) 856-1049

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
23682
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
174568900
MN
Enumeration date
09/29/2005
Last updated
01/03/2019
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