Individual
MR. WILLIAM NICHOLS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
12940 HARRIET AVE S, BURNSVILLE, MN 55337-2680
(952) 830-4061
Mailing address
PO BOX 426, SAINT FRANCIS, MN 55070-0426
(763) 444-4111
(763) 444-4488
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
360
MN
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
360
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0708630001
ADMINASTAR
MN
01
—
106186
UCARE
MN
05
—
113225300
—
MN
01
—
2728397
MEDICA
MN
01
—
64D27NI
BCBS
MN
01
—
980740974001
PREFERRED ONE
MN
01
—
HP14063
HEALTH PARTNERS
MN
Enumeration date
06/20/2005
Last updated
02/18/2013
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