| Roller Neurology | |
|
4399 S Columbia Rd Ste 104 Grand Forks ND 58201-2833 | |
| (701) 317-9000 | |
| (833) 673-0535 |
| Full Name | Roller Neurology |
|---|---|
| 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 |
|---|---|
| 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 |
|---|---|
| Provider Enumeration Date | 04/19/2021 |
| Last Update Date | 07/27/2021 |
| Certification Date | 06/30/2021 |
| Medicare PECOS PAC ID | 8820407661 |
|---|---|
| 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 |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1033283379 PECOS PAC ID: 6507866977 Enrollment ID: I20070109000194 |
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