Individual
SAMANTHA MOLLMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
310 N 10TH ST, BISMARCK, ND 58501-4516
(701) 530-7500
Mailing address
310 N 10TH ST, BISMARCK, ND 58501-4516
(701) 530-7500
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PAC0726
ND
363AM0700X
Medical Physician Assistant
PA0004002
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P01579435
RAILROAD MEDICARE
—
Enumeration date
09/25/2014
Last updated
06/04/2024
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