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Organization

MERCY MEDICAL CENTER, DBA MERCY HEALTH PARTNERS SPECIALTY GROUP

Active
Organization subpart
No

Provider details

NPI number
Authorized official
KERRY S. MONSON (VP FINANCE AND CFO)
(701) 774-7408
Entity
Organization

Contact information

Practice address
1301 15TH AVE W, WILLISTON, ND 58801-3821
(701) 774-7470
(701) 774-7479
Mailing address
1301 15TH AVE W, WILLISTON, ND 58801-3821
(701) 774-7470
(701) 774-7479

Taxonomy

Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
3132
ND
207X00000X
Orthopaedic Surgery Physician
3888
ND
208600000X
Surgery Physician
10618
ND

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
12754
ND
01
711005
BCBS OF ND
ND
Enumeration date
11/17/2006
Last updated
02/12/2008
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