# DR. R TWARDOWSKI MD PC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1053655795
- **Authorized official:** DR. RADOMYSL MARIAN TWARDOWSKI M.D. (CEO)
- **Authorized official phone:** (701) 220-1970

## Contact information

- **Practice address:** 1842 14TH ST S APT 4, FARGO, ND 58103-4842
- **Practice address phone:** (701) 220-1970
- **Mailing address:** 1842 14TH ST S APT 4, FARGO, ND 58103-4842
- **Mailing address phone:** (701) 220-1970

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 171M00000X | Case Manager/Care Coordinator | 6950 | ND | Yes |

## Other

- **Enumeration date:** 11/19/2012
- **Last updated:** 11/26/2012

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 18001 | — | ND |