Individual
BRIAN G WILLOUGHBY
Active
Individual
BRIAN G WILLOUGHBY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
5103
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0568253
—
IA
01
—
10781
ND BLUE CROSS/BLUE SHIELD
—
01
—
123993
WORKER'S COMP
ND
05
—
14656
—
ND
01
—
25451
SIOUX VALLEY
—
05
—
3018140
—
WA
05
—
45034068812
—
NE
05
—
7088230-00
—
MN
05
—
7776070
—
SD
Enumeration date
10/03/2006
Last updated
02/03/2014
Update your record
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