Organization
IAN L GREYBULL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHAWNA ZASTOUPIL RHIT (DIRECTOR OF CODING/BILLING)
(701) 323-9900
Entity
Organization
Contact information
Practice address
300 W CENTURY AVE, BISMARCK, ND 58503-1405
(701) 323-9900
(701) 323-9911
Mailing address
300 W CENTURY AVE, BISMARCK, ND 58503-1405
(701) 323-9900
(701) 323-9911
Taxonomy
Speciality
Code
Description
License number
State
261QH0100X
Health Service Clinic/Center
Primary
R29280
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
84140
—
ND
Enumeration date
02/08/2012
Last updated
05/30/2012
Update your record
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