Tinsatul, Udom

Tinsatul, Udom is an individual health care provider with primary practice located at 612 Center Ave N , Ashley ND 58413-7013. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Surgery, Allopathic & Osteopathic Physicians / General Practice. Allopathic & Osteopathic Physicians / General Practice is his primary health care specialty. Tinsatul, Udom can be contacted via phone (701) 288-3431.

Contact Information

Primary practice address
612 Center Ave N Ashley ND 58413-7013
Phone: (701) 288-3431
Fax: (701) 288-3432
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Surgery 208600000X 3926 North Dakota
Allopathic & Osteopathic Physicians / Surgery 208600000X 2268 South Dakota
Allopathic & Osteopathic Physicians / General Practice 208D00000X 3926 North Dakota

Profile Details

NPI number 1508963950
LBN Legal business name Tinsatul, Udom
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 20th, 2006
Last updated Mar 5th, 2015 - about 10 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 1508963950 NPPES
Other 450359987 CHAMPUS
MEDICAID 12755 CHAMPUS
Other 1714 CHAMPUS
Other 450359987000 CHAMPUS
MEDICAID 7775690 CHAMPUS

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