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Organization

BISMARCK CANCER CENTER

Active
Organization subpart
No

Provider details

NPI number
Authorized official
LOLITA DUTTON (FINANCIAL AND SUPPORT SERVICES MANA)
(701) 222-6102
Entity
Organization

Contact information

Practice address
500 N 8TH ST, BISMARCK, ND 58501-4445
(701) 222-6100
(701) 222-6150
Mailing address
500 N 8TH ST, BISMARCK, ND 58501-4445
(701) 222-6100
(701) 222-6150

Taxonomy

Speciality
Code
Description
License number
State
2085R0001X
Radiation Oncology Physician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
11128
ND
01
1356585293
BCBS OF ND
ND
05
14991
ND
05
15295
ND
01
1558450841
BCBS OF ND
ND
01
24-00348
MEDICA
ND
01
24-00390
MEDICA
ND
01
P00779537
RAIL ROAD MEDICARE
Enumeration date
01/18/2007
Last updated
01/05/2017
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