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Organization
BISMARCK CANCER CENTER
Active
Organization
BISMARCK CANCER CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LOLITA DUTTON (FINANCIAL AND SUPPORT SERVICES MANA)
(701) 222-6102
Entity
Organization
Contact information
Practice address
500 N 8TH ST, BISMARCK, ND 58501-4445
(701) 222-6100
(701) 222-6150
Mailing address
500 N 8TH ST, BISMARCK, ND 58501-4445
(701) 222-6100
(701) 222-6150
Taxonomy
Speciality
Code
Description
License number
State
2085R0001X
Radiation Oncology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
11128
—
ND
01
—
1356585293
BCBS OF ND
ND
05
—
14991
—
ND
05
—
15295
—
ND
01
—
1558450841
BCBS OF ND
ND
01
—
24-00348
MEDICA
ND
01
—
24-00390
MEDICA
ND
01
—
P00779537
RAIL ROAD MEDICARE
—
Enumeration date
01/18/2007
Last updated
01/05/2017
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