Individual
NICKOLAS WILLIAMS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
9555 UPLAND LN N, MAPLE GROVE, MN 55369-4485
(952) 993-1440
Mailing address
8170 33RD AVE S # MS 21110Q, BLOOMINGTON, MN 55425-4516
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
R-10976
IA
2084P0800X
Psychiatry Physician
Primary
DO-05601
IA
Other
Enumeration date
06/05/2017
Last updated
09/19/2023
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