Provider Demographics
NPI:1528145596
Name:WILLIAMS, ELIZABETH KARSCHNIA (MD)
Entity type:Individual
Prefix:DR
First Name:ELIZABETH
Middle Name:KARSCHNIA
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:MS
Other - First Name:ELIZABETH
Other - Middle Name:JEAN
Other - Last Name:KARSCHNIA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:657 MCLEAN AVE
Mailing Address - Street 2:
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55106-6310
Mailing Address - Country:US
Mailing Address - Phone:651-771-7168
Mailing Address - Fax:
Practice Address - Street 1:580 RICE ST
Practice Address - Street 2:
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55103-2148
Practice Address - Country:US
Practice Address - Phone:651-227-6551
Practice Address - Fax:651-665-0684
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN46902207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI34575800Medicaid
MNO-21657700Medicaid
IAO-583179Medicaid
MNL15059Medicare UPIN
IAO-583179Medicaid