Organization
CARL JOHN FEDYSZYN, M.D.,P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CARL JOHN FEDYSZYN M.D. (PRESIDENT)
(701) 330-9616
Entity
Organization
Contact information
Practice address
4550 47TH ST S APT 102, FARGO, ND 58104-4360
(701) 330-9616
Mailing address
4550 47TH ST S APT 102, FARGO, ND 58104-4360
(701) 330-9616
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
7326
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
12146
—
ND
Enumeration date
01/29/2007
Last updated
04/20/2008
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