Individual
DR. SEAN DUSTIN WILLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
2000 N VILLAGE AVE STE 211, ROCKVILLE CENTRE, NY 11570-1001
(516) 714-3743
Mailing address
PO BOX 100108, GAINESVILLE, FL 32610-0108
(352) 265-0535
(352) 627-4173
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
321467
NY
2086S0102X
Surgical Critical Care Physician
321467
NY
2086S0127X
Trauma Surgery Physician
OS20663
FL
Other
Enumeration date
04/12/2018
Last updated
08/18/2025
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