Individual
DR. NILES NILES BATDORF
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1101 9TH ST N, VIRGINIA, MN 55792-2329
(218) 741-0150
Mailing address
1101 9TH ST N, VIRGINIA, MN 55792-2329
(218) 741-0150
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
25508
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
509360100
—
MN
Enumeration date
01/11/2006
Last updated
05/06/2011
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