Individual
MARK S KRISTY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1000 HIGHWAY 12, HETTINGER, ND 58639-7530
(701) 567-4561
(701) 567-6363
Mailing address
1000 HIGHWAY 12, HETTINGER, ND 58639-7530
(701) 567-4561
(701) 567-6363
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
7219
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
13032
BC/BS
ND
05
—
18409
—
ND
05
—
1914556
—
IA
05
—
4503468812
—
NE
05
—
658162-00
—
MN
05
—
7781732
—
SD
01
—
A13801044310
PREFERREDONE
—
Enumeration date
09/20/2006
Last updated
07/08/2007
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