Individual
DR. WILLIAM FREDERIC NORTHRUP III
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4770 WHITE BEAR PKWY, LOWER LEVEL, WHITE BEAR LAKE, MN 55110-3394
(651) 653-1850
(651) 426-6439
Mailing address
4702 LAKEVIEW DR, MINNEAPOLIS, MN 55424-1520
(925) 926-6913
(651) 426-6439
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
20586
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
108709
UCARE
MN
01
—
109263
HEALTHPARTNERS
MN
01
—
18-00157
MEDICA
MN
01
—
202741675 55110 A001
TRICARE
MN
01
—
536K0NO
BLUE CROSS BLUE SHIELD MN
MN
01
—
A57110010519
PREFERRED ONE
MN
Enumeration date
04/14/2006
Last updated
07/08/2007
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