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General NPI Number Information
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NPI Number | 1407928690
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Entity Type | Individual
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Provider Name | DAVID GEORGE ONDICH M.D.
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Gender | Male
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Dates
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Enumeration Date | 11/14/2006
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Last Update Date | 12/16/2013
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Provider Practice Location Address
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Address Line | 1919 UNIVERSITY AVE W SUITE 200
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City | SAINT PAUL
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State | MN
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Zip | 55104-3453
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Country | US
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Telephone | 651-266-7999
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Fax | 651-266-7850
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Provider Business Mailing Address
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Address Line | 1919 UNIVERSITY AVE W SUITE 200
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City | SAINT PAUL
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State | MN
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Zip | 55104-3453
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Country | US
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Telephone | 651-266-7999
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Fax | 651-266-7850
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 36656
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License Number State | MN
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Taxonomy #2
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 2914
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License Number State | AK
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