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Individual

JAN LEVORA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
900 E BROADWAY AVE, BISMARCK, ND 58501-4520
(701) 530-7000
Mailing address
PO BOX 997, BISMARCK, ND 58502-0997
(701) 530-7000

Taxonomy

Speciality
Code
Description
License number
State
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
Primary
10666
ND
207RN0300X
Nephrology Physician
10666
ND

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
10666
LICENSE
ND
05
1454170
ND
01
P00441492
RAILROAD MEDICARE
ND
Enumeration date
10/09/2007
Last updated
03/07/2023
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