Individual
EVGUENI E KOUZNETSOV
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
700 1ST AVE S, FARGO, ND 58103-1802
(701) 234-4036
Mailing address
PO BOX 2168, FARGO, ND 58107-2168
(701) 234-2119
Taxonomy
Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
Primary
LT13937
ND
Other
Enumeration date
12/08/2015
Last updated
04/01/2016
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