Individual
AIDA DUNAMALYAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
510 4TH STREET S, FARGO, ND 58103
(701) 476-7208
Mailing address
2540 36TH AVE SW, 310, FARGO, ND 58104
(701) 280-2457
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
10092
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
74116000
—
MN
01
—
78G11DU
BCBS
MN
Enumeration date
10/05/2006
Last updated
07/08/2007
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