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General NPI Number Information
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NPI Number | 1114199635
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Entity Type | Organization
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Legal Business Name | MEDICAL ARTS PHYSICIANS LTD
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Dates
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Enumeration Date | 03/25/2008
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Last Update Date | 09/18/2008
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Provider Practice Location Address
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Address Line | 614 DAKOTA AVE
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City | WAHPETON
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State | ND
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Zip | 58075-4300
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Country | US
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Telephone | 701-642-4471
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Fax | 701-642-2878
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Provider Business Mailing Address
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Address Line | 614 DAKOTA AVE
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City | WAHPETON
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State | ND
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Zip | 58075-4300
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Country | US
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Telephone | 701-642-4471
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Fax | 701-642-2878
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Authorized Official
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Title or Position | MEDICAL PRACTICE MANAGER
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Name | DEYON M SUCHLA
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Credential |
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Telephone | 701-476-8414
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 3751
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License Number State | ND
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