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Individual

MANDY LEA SORLIE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
904 5TH AVE NE, JAMESTOWN, ND 58401-3437
(701) 253-4020
Mailing address
904 5TH AVE NE, JAMESTOWN, ND 58401-3437
(701) 253-4020

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
11582
ND
208D00000X
General Practice Physician
11013734A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
11013734A
MEDICAL RESIDENCY PERMIT
IN
Enumeration date
07/06/2007
Last updated
05/07/2012
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