Provider Demographics
NPI:1326054180
Name:SYPURA, WILLIAM DONALD (MD)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:DONALD
Last Name:SYPURA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:2025 SLOAN PL STE 35
Mailing Address - Street 2:
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55117-2092
Mailing Address - Country:US
Mailing Address - Phone:651-772-1572
Mailing Address - Fax:651-772-1889
Practice Address - Street 1:8325 CITY CENTRE DR
Practice Address - Street 2:
Practice Address - City:WOODBURY
Practice Address - State:MN
Practice Address - Zip Code:55125-3323
Practice Address - Country:US
Practice Address - Phone:651-731-0859
Practice Address - Fax:651-731-0976
Is Sole Proprietor?:No
Enumeration Date:2006-08-01
Last Update Date:2022-07-06
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MN39878207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN1020258OtherPREFERRED ONE
MN0103682OtherMEDICA
MN6603858OtherMEDICA URGENT CARE
MN7541051OtherAETNA INS
MNHP29314OtherHEALTHPARTNERS
MN856514OtherAMERICA'S PPO
MN356727300Medicaid
MN122097OtherUCARE MN
MN74D17SYOtherBCBS OF MN
MN080146542Medicare ID - Type UnspecifiedRR MEDICARE
MN0103682OtherMEDICA
MN1020258OtherPREFERRED ONE