| Carl John Fedyszyn, M.d.,p.c. | |
|
4550 47th St S Apt 102 Fargo ND 58104-4360 | |
| (701) 330-9616 | |
| Not Available |
| Full Name | Carl John Fedyszyn, M.d.,p.c. |
|---|---|
| Speciality | Family Medicine |
| Location | 4550 47th St S Apt 102, Fargo, North Dakota |
| Authorized Official Name and Position | Carl John Fedyszyn (PRESIDENT) |
| Authorized Official Contact | 7013309616 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Carl John Fedyszyn, M.d.,p.c. 4550 47th St S Apt 102 Fargo ND 58104-4360 Ph: (701) 330-9616 | Carl John Fedyszyn, M.d.,p.c. 4550 47th St S Apt 102 Fargo ND 58104-4360 Ph: (701) 330-9616 |
| NPI Number | 1679619860 |
|---|---|
| Provider Enumeration Date | 01/29/2007 |
| Last Update Date | 04/20/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1679619860 | NPI | - | NPPES |
| 12146 | Medicaid | ND |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 7326 (North Dakota) | Primary |
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