Individual
ANTRANIK MANGARDICH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1300 S COLUMBIA RD, GRAND FORKS, ND 58201
(701) 780-2300
Mailing address
1300 SOUTH COLUMBIA ROAD, GRAND FORKS, ND 58201
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
15289
ND
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
15289
ND
207RP1001X
Pulmonary Disease Physician
Primary
15289
ND
Other
Enumeration date
06/27/2013
Last updated
07/11/2019
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