Individual
JOHANES I. PRAWIRA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
300 N 7TH ST, BISMARCK, ND 58501-4439
(701) 323-6000
(701) 323-6719
Mailing address
PO BOX 5074, SIOUX FALLS, SD 57117-5074
(605) 328-6585
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
12013
ND
207Q00000X
Family Medicine Physician
61703
MN
208M00000X
Hospitalist Physician
Primary
12013
ND
Other
Enumeration date
06/30/2009
Last updated
02/10/2023
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