Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Dr. David John Willis, MD

Individual provider Surgery Physician · NPI 1760537534

Dr. David John Willis, MD is a Colorectal Surgery (Proctology) in St Louis Park, Minnesota. Graduated from New York University School of Medicine in 1999, 27 years ago. Practices with Park Nicollet Clinic, a 1,773-clinician group, accepts Medicare assignment and offers telehealth. Licensed in Minnesota.

Years since qualifying
27
Trained at
New York University School of Medicine
Licensed in
MN
In the registry since
2007
Specialties on file
2
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

3931 Louisiana Ave S Meadowbrook Bldg Ste W-200
St Louis Park, MN 55426-4375
Phone: (952) 993-3466
Fax: (952) 993-3653
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Colon & Rectal Surgery Physician (primary) Taxonomy 208C00000X · Licence 48801 (MN)
Surgery Physician Taxonomy 208600000X · Licence 48801 (MN)

Record details

NPI number1760537534
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorYes
NPI enumeratedJanuary 24, 2007
Last updated in NPPESJuly 2, 2021
Certification dateJuly 2, 2021

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyCOLORECTAL SURGERY (PROCTOLOGY)
Also practisesGENERAL SURGERY
Medical schoolNEW YORK UNIVERSITY SCHOOL OF MEDICINE
Graduated 1999 (27 years in practice)
Group practice Park Nicollet Clinic — 1773 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services

Other providers in St Louis Park