Healthcare Provider Details

I. General information

NPI: 1477554301
Provider Name (Legal Business Name): WILLIAM MITCHEL SEE MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: W. MIKE SEE M.D.

II. Dates (important events)

Enumeration Date: 08/02/2005
Last Update Date: 08/21/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2003 WEST BROADWAY SUITE 100 BROADWAY URGENT CARE
COLUMBIA MO
65202
US

IV. Provider business mailing address

1508 WOODRAIL AVE
COLUMBIA MO
65203-0924
US

V. Phone/Fax

Practice location:
  • Phone: 573-777-5880
  • Fax: 573-777-5875
Mailing address:
  • Phone: 573-864-9500
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number36210
License Number StateMO
# 2
Primary TaxonomyY
Taxonomy Code208G00000X
TaxonomyThoracic Surgery (Cardiothoracic Vascular Surgery) Physician
License Number36210
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: