Provider Demographics
NPI:1154308757
Name:SHARER, WILLIAM C
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:C
Last Name:SHARER
Suffix:
Gender:M
Credentials:
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Mailing Address - Street 1:6465 WAYZATA BLVD
Mailing Address - Street 2:STE 315
Mailing Address - City:ST LOUIS PARK
Mailing Address - State:MN
Mailing Address - Zip Code:55426-1728
Mailing Address - Country:US
Mailing Address - Phone:952-993-7169
Mailing Address - Fax:952-993-0300
Practice Address - Street 1:3900 PARK NICOLLET BLVD
Practice Address - Street 2:PARK NICOLLET CLINIC - SLP
Practice Address - City:ST LOUIS PARK
Practice Address - State:MN
Practice Address - Zip Code:55416-2503
Practice Address - Country:US
Practice Address - Phone:952-993-3017
Practice Address - Fax:952-993-1751
Is Sole Proprietor?:No
Enumeration Date:2005-12-27
Last Update Date:2011-10-11
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Provider Licenses
StateLicense IDTaxonomies
MN30695208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology