Provider Demographics
NPI:1477554301
Name:SEE, WILLIAM MITCHEL (MD)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:MITCHEL
Last Name:SEE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:W.
Other - Middle Name:MIKE
Other - Last Name:SEE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:1508 WOODRAIL AVE
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:MO
Mailing Address - Zip Code:65203-0924
Mailing Address - Country:US
Mailing Address - Phone:573-864-9500
Mailing Address - Fax:
Practice Address - Street 1:2003 WEST BROADWAY SUITE 100
Practice Address - Street 2:BROADWAY URGENT CARE
Practice Address - City:COLUMBIA
Practice Address - State:MO
Practice Address - Zip Code:65202
Practice Address - Country:US
Practice Address - Phone:573-777-5880
Practice Address - Fax:573-777-5875
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-02
Last Update Date:2018-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO36210208D00000X, 208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)
No208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO202627220Medicaid
MO941635236Medicare PIN
MO941631108Medicare PIN
MOP00195409Medicare PIN
MO780001371Medicare PIN
E59595Medicare UPIN