Healthcare Provider Details
I. General information
NPI: 1013029222
Provider Name (Legal Business Name): WILLIAM E. BILJAN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 09/01/2006
Last Update Date: 01/08/2008
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
5814 GRAHAM AVE SUITE 100
SUMNER WA
98390-2728
US
IV. Provider business mailing address
5814 GRAHAM AVE SUITE 100
SUMNER WA
98390-2728
US
V. Phone/Fax
- Phone: 253-863-4474
- Fax: 253-863-4062
- Phone: 253-863-4474
- Fax: 253-863-4062
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207Q00000X |
| Taxonomy | Family Medicine Physician |
| License Number | MD00016345 |
| License Number State | WA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: