Individual
DR. MICHAEL DAVID MANCHAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
700 1ST AVE S, FARGO, ND 58103-1802
(701) 234-4036
(701) 234-4050
Mailing address
PO BOX 2168, FARGO, ND 58107-2168
(701) 234-2119
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
13363
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
81189
—
ND
Enumeration date
03/27/2009
Last updated
02/18/2020
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