MEDICARE: DR. MARVIN MYRON EBERTS D.C

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
1	111N00000X	Chiropractor	851	ND

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1841526688
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MARVIN MYRON EBERTS D.C

Provider Business Mailing Address
First Line	:	193 24TH ST E STE 102
Second Line	:
City	:	DICKINSON
State	:	ND
Zip	:	58601-6580
Country	:	US
Telephone Number	:	701-225-3536
Fax Number	:	701-483-3523

Provider Business Practice Location Address
First Line	:	193 24TH ST E STE 102
Second Line	:
City	:	DICKINSON
State	:	ND
Zip	:	58601-6580
Country	:	US
Telephone Number	:	701-225-3536
Fax Number	:	701-483-3523

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/29/2009
Last Update Date	:	10/31/2023

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