Individual
ELISA WILLIAMS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
801 BROADWAY N, FARGO, ND 58102-3641
(701) 234-6355
Mailing address
400 EAST THIRD STREET, ESSENTIA HEALTH DULUTH CLINIC MCL2CRED, DULUTH, MN 55805-1951
(218) 786-1183
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
11667
ND
207Q00000X
Family Medicine Physician
R7890
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1598857088
—
MN
Enumeration date
09/29/2006
Last updated
11/01/2017
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