Individual
JUSTIN MAUCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1200 S COLUMBIA RD, GRAND FORKS, ND 58201
(701) 780-5000
(701) 780-4477
Mailing address
2401 DEMERS AVE, GRAND FORKS, ND 58201
(701) 780-1891
(701) 780-4477
Taxonomy
Speciality
Code
Description
License number
State
2085N0700X
Neuroradiology Physician
Primary
PT15146
ND
2085R0202X
Diagnostic Radiology Physician
107077
MN
2085R0202X
Diagnostic Radiology Physician
56991
MN
2085R0202X
Diagnostic Radiology Physician
PT15146
ND
Other
Enumeration date
07/25/2012
Last updated
06/15/2018
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