Individual
DR. STEPHAN PODRYGULA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
600 22ND AVE NW, NORTHLAND PROFESSIONAL BUILDING, MINOT, ND 58703-0986
(701) 852-9113
(701) 838-0779
Mailing address
600 22ND AVE NW, NORTHLAND PROFESSIONAL BUILDING, MINOT, ND 58703-0986
(701) 852-9113
(701) 838-0779
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
136
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
16946
—
ND
01
—
POD5241
BLUE CROSS BLUE SHIELD
ND
Enumeration date
09/13/2005
Last updated
02/27/2009
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