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Organization

PATHOLOGY SERVICES

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. JOHN B ANDELIN M.D. (PARTNER)
(701) 572-3800
Entity
Organization

Contact information

Practice address
1301 15TH AVE W, WILLISTON, ND 58801-3821
(701) 572-3800
(701) 774-7402
Mailing address
201 2ND AVE W, WILLISTON, ND 58801-5920
(701) 572-3800
(701) 774-7402

Taxonomy

Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
4911
ND
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
5162
ND

Other

Enumeration date
03/16/2007
Last updated
02/26/2008
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