WILLIAM NATHAN LISBERG MD NPI 1003816075

NPI Information

NPI: 1003816075
Provider Name: WILLIAM NATHAN LISBERG, MD
Classification: Radiology - 2085R0202X
Entity Type: Individual

Specialization: Diagnostic Radiology

PECOS Registration: Yes

Address:
3300 OAKDALE AVE N
ROBBINSDALE, MN
ZIP 55422
Phone: (763) 559-2171
Get Directions

William Nathan Lisberg, MD is a diagnostic radiology radiology in Robbinsdale, MN. The provider is a radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. William Nathan Lisberg, MD NPI is 1003816075. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

3300 OAKDALE AVE N
ROBBINSDALE, MN
ZIP 55422-926
Phone: (763) 559-2171
Fax: (763) 694-9000

The NPI 1003816075 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 7/29/2005 and was last updated on 3/3/2009.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	2085U0001X	Radiology	Diagnostic Ultrasound	28413	MINNESOTA	No
2	2085B0100X	Radiology	Body Imaging	28413	MINNESOTA	No
3	2085N0700X	Radiology	Neuroradiology	28413	MINNESOTA	No
4	2085N0904X	Radiology	Nuclear Radiology	28413	MINNESOTA	No
5	2085R0202X	Radiology	Diagnostic Radiology	28413	MINNESOTA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State
1	A95764	MEDICARE UPIN
2	300000063	MEDICARE ID-TYPE UNSPECIFIED
3	893072400	MEDICAID	MINNESOTA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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