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Organization
REGIONAL MEDICAL CENTER PC
Active
Organization
REGIONAL MEDICAL CENTER PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
VICKI L BOEHM (BUSINESS MANAGER)
(701) 667-1022
Entity
Organization
Contact information
Practice address
2008 TWIN CITY DR, MANDAN, ND 58554-3820
(701) 667-1000
(701) 667-0707
Mailing address
2008 TWIN CITY DR, MANDAN, ND 58554-3820
(701) 667-1000
(701) 667-0707
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
4124
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1051140001
DMERC CIGNA
ND
05
—
13249
—
ND
01
—
7709620
SD MEDICAID
SD
01
—
C52498
PALMETTO GBA
ND
Enumeration date
07/05/2006
Last updated
08/14/2009
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