Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223G0001X | General Practice | 2334 | ND |
Y | 213EG0000X | General Practice | 2334 | ND |
NPI | 1003307182 |
---|---|
Provider Name | Arjan Majidian |
First Address | Fargo, ND 58103-8722 |
Second Address | Fargo, ND 58103-8722 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 23/05/2018 |
Last Update Date | 23/05/2018 |