| Northern Valley Obstetrics & Gynecology, P.c. | |
|
2810 17th Ave S Grand Forks ND 58201-4010 | |
| (701) 738-2004 | |
| Not Available |
| Full Name | Northern Valley Obstetrics & Gynecology, P.c. |
|---|---|
| Speciality | Clinic/Center |
| Location | 2810 17th Ave S, Grand Forks, North Dakota |
| Authorized Official Name and Position | Rory Trottier (PRESIDENT) |
| Authorized Official Contact | 7017382004 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Northern Valley Obstetrics & Gynecology, P.c. 2810 17th Ave S Grand Forks ND 58201-4010 Ph: (701) 738-2004 | Northern Valley Obstetrics & Gynecology, P.c. 2810 17th Ave S Grand Forks ND 58201-4010 Ph: (701) 738-2004 |
| NPI Number | 1194778035 |
|---|---|
| Provider Enumeration Date | 05/19/2006 |
| Last Update Date | 02/24/2015 |
| Medicare PECOS PAC ID | 8628084365 |
|---|---|
| Medicare Enrollment ID | O20060303000549 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1194778035 | NPI | - | NPPES |
| N711838 | Other | ND | PTAN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | 8135 (North Dakota) | Primary |
| Provider Name | Rory D Trottier |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1427002930 PECOS PAC ID: 9931115672 Enrollment ID: I20060306000256 |
| Provider Name | Kari D Wessman |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1235150574 PECOS PAC ID: 6800948431 Enrollment ID: I20101028000690 |
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