Full Name | |
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Speciality | Family Medicine |
Location | No. 2 3rd Ave. Sw, Towner, North Dakota |
Authorized Official Name and Position | Dawn Berg (CEO) |
Authorized Official Contact | 7018737788 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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1312 Highway 49 N Beulah ND 58523-6038 Ph: (701) 873-7788 | No. 2 3rd Ave. Sw Towner ND 58788 Ph: (701) 537-2007 |
NPI Number | 1912143868 |
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Provider Enumeration Date | 12/24/2008 |
Last Update Date | 12/24/2008 |
Identifier | Type | State | Issuer |
---|---|---|---|
1912143868 | NPI | - | NPPES |
05909 | Medicaid | ND |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | (* (Not Available)) | Primary |