Provider Demographics
NPI:1508841735
Name:EELKEMA, WILLIAM HARRISON (MD)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:HARRISON
Last Name:EELKEMA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:538 DAYTON AVE
Mailing Address - Street 2:
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55102-1710
Mailing Address - Country:US
Mailing Address - Phone:651-207-6174
Mailing Address - Fax:
Practice Address - Street 1:538 DAYTON AVE
Practice Address - Street 2:
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55102-1710
Practice Address - Country:US
Practice Address - Phone:651-207-6174
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-12-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN46188207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine