Individual
DR. DAVID JOHN WILLIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3931 LOUISIANA AVE S, MEADOWBROOK BLDG SUITE W-200, ST LOUIS PARK, MN 55426-4375
(952) 993-3466
(952) 993-3653
Mailing address
8170 33RD AVE S # MS 21110Q, BLOOMINGTON, MN 55425-4516
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
48801
MN
208C00000X
Colon & Rectal Surgery Physician
Primary
48801
MN
Other
Enumeration date
01/24/2007
Last updated
07/02/2021
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