Individual
MARK A EMMERICH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
34 FIRST STREET EAST, DICKINSON, ND 58601-5106
(701) 225-9601
(701) 483-9601
Mailing address
34 FIRST STREET EAST, DICKINSON, ND 58601-5106
(701) 225-9601
(701) 483-9601
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
379
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
410004275
TRAVLERS
—
05
—
60252
—
ND
01
—
800379
NDVS
ND
01
—
EMM8814
BCBS
ND
Enumeration date
05/03/2006
Last updated
01/12/2012
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