Rodacker, Mark Wade
Rodacker, Mark Wade is an individual health care provider with primary practice located at 1200 S Columbia Rd - Altru Hospital , Grand Forks ND 58201. He recently has only one registered license in Allopathic & Osteopathic Physicians / Clinical Pathology/Laboratory Medicine, which is considered as his primary health care specialty. Rodacker, Mark Wade can be contacted via phone (701) 780-1561.Contact Information
Primary practice address
1200 S Columbia Rd - Altru Hospital
Grand Forks ND 58201
Phone: (701) 780-1561
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Clinical Pathology/Laboratory Medicine | 207ZP0105X | 9611 | North Dakota |
Profile Details
| NPI number | 1437261724 |
|---|---|
| LBN Legal business name | Rodacker, Mark Wade |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Aug 31st, 2006 |
| Last updated | Feb 25th, 2019 - about 6 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1437261724 | NPPES |
| North Dakota | MEDICAID | 12927 |
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