Provider Demographics
NPI:1649382292
Name:NOYES, WILLIAM RICHARD (MD)
Entity Type:Individual
Prefix:MR
First Name:WILLIAM
Middle Name:RICHARD
Last Name:NOYES
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 1:1451 44TH AVE S, UNIT E
Mailing Address - Street 2:
Mailing Address - City:GRAND FORKS
Mailing Address - State:ND
Mailing Address - Zip Code:58201-3434
Mailing Address - Country:US
Mailing Address - Phone:701-787-5800
Mailing Address - Fax:
Practice Address - Street 1:1451 44TH AVE S
Practice Address - Street 2:UNIT E
Practice Address - City:GRAND FORKS
Practice Address - State:ND
Practice Address - Zip Code:58201-3434
Practice Address - Country:US
Practice Address - Phone:701-787-5800
Practice Address - Fax:701-787-5802
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2020-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN396732085R0001X
ND69182085R0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN965522100Medicaid
97893OtherPREFERRED ONE
P00178255OtherRR MEDICARE
P11216603OtherMULTIPLAN
ND18505Medicaid
2400209OtherMEDICA
ND24591OtherBLUE CROSS NORTH DAKOTA
MN273L7NOOtherBLUE CROSS MINNESOTA
HP45237OtherHEALTH PARTNERS
201200995001OtherUNICARE
P00178255OtherRR MEDICARE
HP45237OtherHEALTH PARTNERS