Individual
WILLIAM CLIFFORD BROSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.,
Contact information
Practice address
12131 ELM CREEK BLVD N, MAPLE GROVE, MN 55369-7093
(763) 416-1983
(763) 416-4084
Mailing address
6632 FLAG AVE N, BROOKLYN PARK, MN 55428-1853
(763) 535-7011
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
MN1544
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
121823900
—
MN
01
—
168L0BR
BLUE CROSS BLUE SHIELD
MN
01
—
1808007
DEFINITY HEALTH
MN
01
—
219101033314
PREFERED ONE
MN
01
—
2202190
MEDICA
MN
01
—
BR952237
HIGHMARK BLUE CROSS
MN
01
—
HP39712
HEALTH PARTNERS
MN
Enumeration date
01/31/2007
Last updated
02/13/2015
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