Organization
HETLAND EAR NOSE THROAT PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANDREW RYAN HETLAND M.D. (PRESIDENT)
(701) 934-1393
Entity
Organization
Contact information
Practice address
2331 TYLER PKWY STE 6, BISMARCK, ND 58503-0871
(701) 258-6851
(701) 258-6852
Mailing address
2331 TYLER PKWY STE 6, BISMARCK, ND 58503-0871
(701) 258-6851
(701) 258-6852
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
11581
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1457302622
PROVIDER NPI
ND
Enumeration date
11/28/2016
Last updated
03/17/2018
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