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Organization
UNIVERSITY OF NORTH DAKOTA
Active
Organization
UNIVERSITY OF NORTH DAKOTA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JODI MYRVIK (BUSINESS MANAGER)
(701) 751-6753
Entity
Organization
Contact information
Practice address
701 E. ROSSER AVE., BISMARCK, ND 58501-4461
(701) 328-9950
(701) 328-9957
Mailing address
701 E. ROSSER AVE., BISMARCK, ND 58501-4461
(701) 751-9500
(701) 751-9508
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
NULL
207Q00000X
Family Medicine Physician
Primary
—
—
261QF0050X
Non-Surgical Family Planning Clinic/Center
—
NULL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
102001
BCBS
ND
05
—
12083
—
ND
05
—
1459002
—
ND
Enumeration date
06/29/2006
Last updated
03/30/2023
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