Individual
DR. MONTE JOHN LEIDENIX
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D. F.A.C.S.
Contact information
Practice address
620 N 9TH ST, BISMARCK, ND 58501-4112
(701) 255-4673
(701) 255-4934
Mailing address
620 N 9TH ST, BISMARCK, ND 58501-4112
(701) 255-4673
(701) 255-4934
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
7678
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
10199
—
ND
05
—
10354900
—
MT
01
—
14737
BLUE SHIELD PROVIDER #
ND
05
—
7780550
—
SD
Enumeration date
10/11/2005
Last updated
01/08/2008
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