Individual
SUMAIYA THAKOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
701 E ROSSER AVE, BISMARCK, ND 58501-4457
(701) 751-9500
Mailing address
701 E ROSSER AVE, BISMARCK, ND 58501-4457
(701) 751-9500
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
RL15942
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1459002
—
ND
Enumeration date
09/10/2019
Last updated
09/10/2019
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