Organization
MEDICAL ARTS PHYSICIANS LTD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DEYON M SUCHLA (MEDICAL PRACTICE MANAGER)
(701) 476-8414
Entity
Organization
Contact information
Practice address
614 DAKOTA AVE, WAHPETON, ND 58075-4300
(701) 642-4471
(701) 642-2878
Mailing address
614 DAKOTA AVE, WAHPETON, ND 58075-4300
(701) 642-4471
(701) 642-2878
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
3751
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00545001
BLUE SHIELD OF ND
ND
05
—
12405
—
ND
Enumeration date
03/25/2008
Last updated
09/18/2008
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