Individual
MARYSE MATHIEU
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
310 N 10TH ST, BISMARCK, ND 58501
(701) 530-7500
(701) 530-7484
Mailing address
310 N 10TH ST, BISMARCK, ND 58501
(701) 530-7500
(701) 530-7484
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
10146
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1700971199
NPI
—
01
—
P00393331
RAILROAD MEDICARE
ND
Enumeration date
10/03/2006
Last updated
02/29/2008
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