Organization
BW MEDICAL PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KIMBERLY J. HAYCRAFT-WILLIAMS MD (OWNER)
(612) 706-9630
Entity
Organization
Contact information
Practice address
4001 STINSON BLVD NE, STE 404, MINNEAPOLIS, MN 55421-3424
(612) 706-9630
(612) 706-9617
Mailing address
17620 DURANT ST NE, HAM LAKE, MN 55304-4602
(763) 413-9462
(612) 706-9617
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
39788
MN
Other
Enumeration date
04/19/2012
Last updated
04/19/2012
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