Roller Neurology | |
4399 S Columbia Rd Ste 104 Grand Forks ND 58201-2833 | |
(701) 317-9000 | |
(833) 673-0535 |
Full Name | Roller Neurology |
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Speciality | Psychiatry & Neurology |
Location | 4399 S Columbia Rd Ste 104, Grand Forks, North Dakota |
Authorized Official Name and Position | Matthew J Roller (OWNER) |
Authorized Official Contact | 7013179000 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Roller Neurology 16771 15th St Ne Buxton ND 58218-9239 Ph: () - | Roller Neurology 4399 S Columbia Rd Ste 104 Grand Forks ND 58201-2833 Ph: (701) 317-9000 |
NPI Number | 1780265009 |
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Provider Enumeration Date | 04/19/2021 |
Last Update Date | 07/27/2021 |
Certification Date | 06/30/2021 |
Medicare PECOS PAC ID | 8820407661 |
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Medicare Enrollment ID | O20210507002337 |
Identifier | Type | State | Issuer |
---|---|---|---|
1780265009 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
2084N0400X | Psychiatry & Neurology - Neurology | (* (Not Available)) | Primary |
Provider Name | Matthew J Roller |
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Provider Type | Practitioner - Neurology |
Provider Identifiers | NPI Number: 1033283379 PECOS PAC ID: 6507866977 Enrollment ID: I20070109000194 |
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