Individual
BHASWATI MONA CHAKRAVORTY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
306 4TH ST N, FARGO, ND 58102-4820
(701) 239-7111
Mailing address
PO BOX 2625, FARGO, ND 58108-2625
(701) 239-7111
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
9609
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
13326
—
ND
Enumeration date
11/03/2006
Last updated
07/08/2007
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