Individual
BRADLEY R STORK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
NP-C
Contact information
Practice address
310 N 9TH ST, BISMARCK, ND 58501-4515
(701) 530-8800
Mailing address
310 N 9TH ST, BISMARCK, ND 58501-4515
(701) 530-8800
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
R27167
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1459578
—
ND
01
—
500018668
MEDICARE RAILROAD
ND
Enumeration date
06/08/2006
Last updated
08/16/2016
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