Individual
MRS. SUSAN MARIE STREITZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LRD, CDE
Contact information
Practice address
725 HAMLINE ST - ALTRU FAMILY MEDICINE RESIDENCY, GRAND FORKS, ND 58203
(701) 780-6400
Mailing address
2401 DEMERS AVE, GRAND FORKS, ND 58201
(701) 780-1891
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
62
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CD3144
MEDICARE RAILROAD GROUP NUMBER
ND
Enumeration date
06/06/2007
Last updated
03/07/2019
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