Healthcare Provider Details

I. General information

NPI: 1558943894
Provider Name (Legal Business Name): NOELLE P OBRITSCH MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: NOELLE P TORRANCE

II. Dates (important events)

Enumeration Date: 04/26/2021
Last Update Date: 09/30/2026
Certification Date: 09/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

765 W INTERSTATE AVE
BISMARCK ND
58503-0936
US

IV. Provider business mailing address

PO BOX 5074
SIOUX FALLS SD
57117-5074
US

V. Phone/Fax

Practice location:
  • Phone: 701-323-3700
  • Fax:
Mailing address:
  • Phone: 605-328-6585
  • Fax: 605-328-6512

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number31754
License Number StateMN
# 2
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number24614
License Number StateND
# 3
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number72060
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: