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NPI Code Detail

MEDICARE: MEDCENTER ONE INC

MEDICARE: MEDCENTER ONE INC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine PhysicianND

General Provider Information

NPI Number : 1629113477
Entity Type Code : Organization
Provider Name (Legal Business Name) : MEDCENTER ONE INC
Provider Business Mailing Address
First Line : PO BOX 5501
Second Line :
City : BISMARCK
State : ND
Zip : 58506-5501
Country : US
Telephone Number : 701-323-6000
Fax Number : 701-323-5709
Provider Business Practice Location Address
First Line : 2830 N WASHINGTON ST
Second Line :
City : BISMARCK
State : ND
Zip : 58503-1482
Country : US
Telephone Number : 701-323-6400
Fax Number : 701-323-5709
Authorized Official
Title or Position : DIRECTOR OF CLINIC FINANCE
Name : LEIGH ANN THOMPSON
Credential :
Telephone Number : 701-323-6000
Provider Enumeration Date : 02/20/2007
Last Update Date : 08/22/2020

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Directions to “MEDCENTER ONE INC ” Practice Location

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