Provider Demographics
NPI:1235459165
Name:WILLGING, JEFFREY PETER (MD)
Entity Type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:PETER
Last Name:WILLGING
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:420 DELAWARE ST SE
Mailing Address - Street 2:DEPARTMENT OF NEUROLOGY, MMC 295
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55455-0341
Mailing Address - Country:US
Mailing Address - Phone:612-625-9900
Mailing Address - Fax:612-625-7950
Practice Address - Street 1:420 DELAWARE ST SE
Practice Address - Street 2:DEPARTMENT OF NEUROLOGY, MMC 295
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55455-0341
Practice Address - Country:US
Practice Address - Phone:612-625-9900
Practice Address - Fax:612-625-7950
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-02
Last Update Date:2010-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program