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Individual

HAROLD T RODENBIKER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
100 4TH ST S STE 612, FARGO, ND 58103-1940
(701) 235-0561
(701) 235-0330
Mailing address
100 4TH ST S STE 612, FARGO, ND 58103-1940
(701) 235-0561
(701) 235-0330

Taxonomy

Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
29919
MN
207W00000X
Ophthalmology Physician
Primary
5102
ND

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
11358
BLUE SHIELD
ND
05
14692
ND
01
2M040RO
BLUE SHIELD
MN
01
892810
VISION SERVICES
ND
Enumeration date
10/11/2006
Last updated
12/12/2007
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