Brose, William Clifford
Brose, William Clifford is an individual health care provider with primary practice located at 12131 Elm Creek Blvd N , Maple Grove MN 55369-7093. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Brose, William Clifford can be contacted via phone (763) 416-1983.Contact Information
Primary practice address
12131 Elm Creek Blvd N
Maple Grove MN 55369-7093
Phone: (763) 416-1983
Fax: (763) 416-4084
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Eye and Vision Services Providers / Optometrist | 152W00000X | MN1544 | Minnesota |
Profile Details
| NPI number | 1801933627 |
|---|---|
| LBN Legal business name | Brose, William Clifford |
| Credentials | Doctor of Optometry (OD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jan 31st, 2007 |
| Last updated | Feb 13th, 2015 - about 10 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1801933627 | NPPES |
| Minnesota | Other | 1808007 | DEFINITY HEALTH |
| Minnesota | Other | 2202190 | DEFINITY HEALTH |
| Minnesota | Other | 168L0BR | DEFINITY HEALTH |
| Minnesota | Other | BR952237 | DEFINITY HEALTH |
| Minnesota | Other | 219101033314 | DEFINITY HEALTH |
| Minnesota | MEDICAID | 121823900 | DEFINITY HEALTH |
| Minnesota | Other | HP39712 | DEFINITY HEALTH |
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