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Individual

LEE PODOLL

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
900 E BROADWAY AVE, BISMARCK, ND 58501-4520
(701) 530-7000
Mailing address
PO BOX 997, BISMARCK, ND 58502-0997
(701) 530-7000

Taxonomy

Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
3872
ND

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1457677
ND
05
591270900
MN
Enumeration date
06/13/2006
Last updated
07/22/2016
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