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Individual

DISA L.G. AWAH

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
DO

Contact information

Practice address
400 BURDICK EXPY E, MINOT, ND 58701-4768
(701) 857-7969
(701) 857-7957
Mailing address
PO BOX 5010, MINOT, ND 58702-5010
(701) 857-5650
(701) 854-5031

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
13345
ND

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
81339
ND
Enumeration date
08/09/2010
Last updated
02/25/2015
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