Individual
DR. JONATHAN MARIAN RODRIGUES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
715 E BROADWAY AVE, BISMARCK, ND 58501-4451
(701) 323-8922
Mailing address
715 E BROADWAY AVE, BISMARCK, ND 58501-4451
(701) 323-8922
Taxonomy
Speciality
Code
Description
License number
State
207K00000X
Allergy & Immunology Physician
Primary
14015
ND
207R00000X
Internal Medicine Physician
14015
ND
208000000X
Pediatrics Physician
2010018334
MO
Other
Enumeration date
07/21/2010
Last updated
12/28/2016
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