Individual
YESHA SHUKLA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
801 BROADWAY N, FARGO, ND 58102-3641
(701) 234-6076
Mailing address
247 ROBERTS ST N APT 704, FARGO, ND 58102-3941
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
RL16685
ND
Other
Enumeration date
06/27/2020
Last updated
06/27/2020
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