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General NPI Number Information
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NPI Number | 1548287634
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Entity Type | Individual
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Provider Name | MICHAEL QUAST MD
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Gender | Male
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Dates
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Enumeration Date | 07/16/2006
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Last Update Date | 03/31/2022
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Provider Practice Location Address
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Address Line | 414 N 7TH ST PAIN CLINIC
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City | BISMARCK
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State | ND
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Zip | 58501-4423
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Country | US
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Telephone | 701-471-5350
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Fax | 701-323-6516
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Provider Business Mailing Address
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Address Line | PO BOX 5074
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City | SIOUX FALLS
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State | SD
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Zip | 57117-5074
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Country | US
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Telephone |
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Fax |
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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 | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | 9061
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License Number State | ND
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Taxonomy #2
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Taxonomy Code | 208VP0014X
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Taxonomy Name | Interventional Pain Medicine Physician
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License Number | ND 9061
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License Number State | ND
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Taxonomy #3
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Taxonomy Code | 208VP0000X
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Taxonomy Name | Pain Medicine Physician
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License Number | 9061
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License Number State | ND
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