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Individual

DR. ROBERT STEVEN RIDDICK

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
30 7TH ST W, DICKINSON, ND 58601-4335
(701) 456-4387
Mailing address
1036C SMOKEY HOLW, DICKINSON, ND 58601-3672
(541) 217-0600

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
12077
ND
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
12077
ND

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
12077
MEDICAL LICENSE
ND
05
545777844A
ND
Enumeration date
06/25/2005
Last updated
11/08/2013
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