Individual
CHATREE WONGJIRAD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
900 E BROADWAY AVENUE, BISMARCK, ND 58501
(701) 530-7000
Mailing address
PO BOX 997, BISMARCK, ND 58502-0997
(701) 530-7000
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
5254
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
130006387
RR MEDICARE
ND
05
—
1450768
—
ND
Enumeration date
10/17/2006
Last updated
07/22/2016
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