Individual
GUY PAUL TANGEDAHL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
515 E BROADWAY, BISMARCK, ND 58501
(701) 751-9500
(701) 751-9508
Mailing address
515 E BROADWAY, BISMARCK, ND 58501
(701) 751-9500
(701) 751-9508
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
4902
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
14301
—
ND
01
—
4778
BCBS
ND
Enumeration date
06/29/2006
Last updated
03/18/2010
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