Individual
RALPH BRYAN PANGILINAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
10 MISSILE AVE, MINOT AFB, ND 58705-5003
(701) 723-5633
Mailing address
10 MISSILE AVE, MINOT AFB, ND 58705-5003
(701) 723-5633
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1501366630
TRICARE
SD
Enumeration date
11/10/2022
Last updated
11/09/2023
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