Organization
MICHIGAN COMMUNITY MEDICAL CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. NATHAN BOYD HAGEN M.D. (PHYSICIAN)
(701) 259-2118
Entity
Organization
Contact information
Practice address
115 SO ST. # 290, MICHIGAN, ND 58259
(701) 259-2118
(701) 259-2319
Mailing address
PO BOX 290, 115 SO ST. # 290, MICHIGAN, ND 58259
(701) 259-2118
(701) 259-2319
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
3113
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
11257
—
ND
Enumeration date
07/31/2014
Last updated
07/31/2014
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