Individual
DR. PUVANALINGAM AYYADURAI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1300 S COLUMBIA RD, GRAND FORKS, ND 58201-4012
(701) 780-2300
Mailing address
2401 DEMERS AVE, GRAND FORKS, ND 58201
(701) 780-4085
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
15887
ND
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
07/10/2014
Last updated
06/02/2020
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