Individual
DR. IVAN JOSE BUSTILLO CHAMS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
ALTRU CANCER CENTER, 960 S. COLUMBIA ROAD, GRAND FORKS, ND 58201
(701) 780-5400
(203) 789-5184
Mailing address
PO BOX 13780, GRAND FORKS, ND 58208
(701) 780-1891
(203) 789-5184
Taxonomy
Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
Primary
PT12924
ND
Other
Enumeration date
09/23/2008
Last updated
01/29/2025
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