Individual
MRS. RICHELLE MELANIE KNUDSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
2830 N WASHINGTON ST, BISMARCK, ND 58503-1482
(701) 323-6400
(701) 323-5677
Mailing address
PO BOX 5074, SIOUX FALLS, SD 57117-5074
(605) 328-6585
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
104460
MN
207N00000X
Dermatology Physician
Primary
12939
ND
207N00000X
Dermatology Physician
52270
MN
390200000X
Student in an Organized Health Care Education/Training Program
RL10955
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
18404
—
ND
05
—
ENROLLED
—
IA
05
—
ENROLLED
—
MN
01
—
P00839007
RAILROAD MEDICARE
MN
Enumeration date
10/17/2008
Last updated
09/23/2015
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