Stork, Bradley R

Stork, Bradley R is an individual health care provider with primary practice located at 310 N 9Th St , Bismarck ND 58501-4515. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as his primary health care specialty. Stork, Bradley R can be contacted via phone (701) 530-8800.

Contact Information

Primary practice address
310 N 9Th St Bismarck ND 58501-4515
Phone: (701) 530-8800
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X R27167 North Dakota

Profile Details

NPI number 1285675728
LBN Legal business name Stork, Bradley R
Credentials NP-C
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 8th, 2006
Last updated Aug 16th, 2016 - about 8 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1285675728 NPPES
North Dakota MEDICAID 1459578
North Dakota Other 500018668

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