Organization
5TH MEDICAL GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERT B LONG (INDEPENDENT DUTY MEDICAL TECHNICIAN)
(701) 723-5190
Entity
Organization
Contact information
Practice address
10 MISSILE AVE, MINOT AFB, ND 58705-5003
(701) 723-5190
Mailing address
10 MISSILE AVE, MINOT AFB, ND 58705-5003
Taxonomy
Speciality
Code
Description
License number
State
2865M2000X
Military General Acute Care Hospital
Primary
B1035530
ND
Other
Enumeration date
09/09/2011
Last updated
09/09/2011
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