Provider Demographics
NPI:1245332311
Name:WILLIAM NOYES, MD PC
Entity type:Organization
Organization Name:WILLIAM NOYES, MD PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:RICHARD
Authorized Official - Last Name:NOYES
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:701-787-5800
Mailing Address - Street 1:1451 44TH AVE
Mailing Address - Street 2:UNIT E
Mailing Address - City:GRAND FORKS
Mailing Address - State:ND
Mailing Address - Zip Code:58201-3434
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1451 44TH AVE S
Practice Address - Street 2:UNIT E
Practice Address - City:GRAND FORKS
Practice Address - State:ND
Practice Address - Zip Code:58201-3434
Practice Address - Country:US
Practice Address - Phone:701-787-5800
Practice Address - Fax:701-787-5802
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-01
Last Update Date:2020-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND6918174400000X
207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & OncologyGroup - Single Specialty
No174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ND13116Medicaid
MN054429900Medicaid
ND06336001OtherBLUE CROSS NORHT DAKOTA
24047OtherMEDICA
MN273L6NOOtherBLUE CROSS OF MINNESOTA
NDDC5897Medicare PIN
MN054429900Medicaid