Healthcare Provider Details

I. General information

NPI: 1235294513
Provider Name (Legal Business Name): MONTANA-DAKOTA UTILITIES CO., A DIVISION OF MDU RESOURCES GROUP INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/27/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 N 4TH ST ATTN DAWN WETZSTEIN
BISMARCK ND
58501-4092
US

IV. Provider business mailing address

400 N 4TH ST ATTN DAWN WETZSTEIN
BISMARCK ND
58501-4092
US

V. Phone/Fax

Practice location:
  • Phone: 701-222-7900
  • Fax: 701-222-7886
Mailing address:
  • Phone: 701-222-7900
  • Fax: 701-222-7886

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number StateWY

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
Identifier0800632
Identifier TypeOTHER
Identifier StateMT
Identifier IssuerINDIVIDUAL PROVIDER
# 2
Identifier33046
Identifier TypeOTHER
Identifier StateND
Identifier IssuerQUALIFIED SERVICE PROVIDE
# 3
Identifier9560460
Identifier TypeMEDICAID
Identifier StateSD
Identifier Issuer

VIII. Authorized Official

Name: MS. DAWN M WETZSTEIN
Title or Position: PRODUCTS & SERVICES COORDINATOR
Credential:
Phone: 701-222-7919