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General NPI Number Information
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NPI Number | 1568847408
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Entity Type | Organization
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Legal Business Name | INDEPENDENT DOCTORS, P.C.
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Dates
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Enumeration Date | 07/21/2015
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Last Update Date | 07/21/2015
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Provider Practice Location Address
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Address Line | 4535 NORTHERN SKY DRIVE SUITE 1
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City | BISMARCK
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State | ND
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Zip | 58503
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Country | US
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Telephone | 701-426-9335
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Fax |
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Provider Business Mailing Address
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Address Line | 4535 NORTHERN SKY DRIVE SUITE 1
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City | BISMARCK
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State | ND
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Zip | 58503
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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 | SECRETARY/TREASURE
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Name | JOY ANN FROELICH
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Credential | M.D.
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Telephone | 573-489-6856
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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