# UNIVERSITY OF NORTH DAKOTA

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

## Provider details

- **NPI number:** 1619905528
- **Authorized official:** JODI MYRVIK (BUSINESS MANAGER)
- **Authorized official phone:** (701) 751-6753

## Contact information

- **Practice address:** 701 E. ROSSER AVE., BISMARCK, ND 58501-4461
- **Practice address phone:** (701) 328-9950
- **Practice address fax:** (701) 328-9957
- **Mailing address:** 701 E. ROSSER AVE., BISMARCK, ND 58501-4461
- **Mailing address phone:** (701) 751-9500
- **Mailing address fax:** (701) 751-9508

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |
| 261QF0050X | Non-Surgical Family Planning Clinic/Center | — | NULL | — |

## Other

- **Enumeration date:** 06/29/2006
- **Last updated:** 03/30/2023

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 102001 | BCBS | ND |
| 05 | — | 12083 | — | ND |
| 05 | — | 1459002 | — | ND |