Individual
DR. MATTHEW RICHARD DEROSIER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
1921 N 13TH ST, BISMARCK, ND 58501-1973
(701) 222-2252
(701) 222-3645
Mailing address
1921 N 13TH ST, BISMARCK, ND 58501-1973
(701) 222-2252
(701) 222-3645
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
3957
MN
111N00000X
Chiropractor
Primary
799
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
10761
—
ND
01
—
30063
BCBSND
ND
01
—
350054947
RAILROAD MEDICARE
MN
01
—
44-88343
MEDICA
MN
01
—
49M33DE
BCBS - MN
MN
01
—
92363
HEALTHPARTNERS
MN
Enumeration date
08/02/2005
Last updated
07/16/2019
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