Healthcare Provider Details
I. General information
NPI: 1497782718
Provider Name (Legal Business Name): ELIZABETH WEST BIZIER MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 06/26/2006
Last Update Date: 05/18/2023
Certification Date: 05/18/2023
Deactivation Date:
Reactivation Date:
III. Provider practice location address
SHRINERS HOSPITAL FOR CHILDREN 215 RADIO DR.
WOODBURY MN
55125
US
IV. Provider business mailing address
215 RADIO DR. SUITE 100
WOODBURY MN
55125
US
V. Phone/Fax
- Phone: 612-596-6100
- Fax: 612-339-7634
- Phone: 612-596-6100
- Fax: 612-339-7634
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207X00000X |
| Taxonomy | Orthopaedic Surgery Physician |
| License Number | 044748 |
| License Number State | CT |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207XP3100X |
| Taxonomy | Pediatric Orthopaedic Surgery Physician |
| License Number | 54315 |
| License Number State | MN |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: