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General NPI Number Information
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NPI Number | 1699741272
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Entity Type | Individual
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Provider Name | HOWARD R GIVENS M.D.
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Gender | Male
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Dates
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Enumeration Date | 02/24/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 319 MDG 1599 J STREET
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City | GRAND FORKS AFB
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State | ND
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Zip | 58205
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Country | US
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Telephone | 701-747-5504
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Fax |
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Provider Business Mailing Address
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Address Line | 3598 14TH AVE S
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City | GRAND FORKS
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State | ND
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Zip | 58201-3704
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 01054607A
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License Number State | IN
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