Provider Demographics
NPI:1104875186
Name:UTZ, WILLIAM JOSEPH (MD)
Entity type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:JOSEPH
Last Name:UTZ
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:6525 FRANCE AVE S
Mailing Address - Street 2:SUITE 200
Mailing Address - City:EDINA
Mailing Address - State:MN
Mailing Address - Zip Code:55435-2148
Mailing Address - Country:US
Mailing Address - Phone:952-927-6501
Mailing Address - Fax:952-653-1435
Practice Address - Street 1:6525 FRANCE AVE S
Practice Address - Street 2:SUITE 200
Practice Address - City:EDINA
Practice Address - State:MN
Practice Address - Zip Code:55435-2148
Practice Address - Country:US
Practice Address - Phone:952-927-6501
Practice Address - Fax:952-653-1435
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-08
Last Update Date:2012-01-26
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Provider Licenses
StateLicense IDTaxonomies
MN30044208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN314307400Medicaid
MN314307400Medicaid
MNE81402Medicare UPIN