Individual
DR. SUSAN M MATHISON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1800 21ST AVE S, FARGO, ND 58103
(701) 365-8700
(701) 365-8701
Mailing address
1800 21ST AVE S, FARGO, ND 58103
(701) 365-8700
(701) 365-8701
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
7819
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
10334
—
ND
Enumeration date
12/04/2006
Last updated
12/07/2011
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