Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208800000X | Urologist | 29669 | MN |
Y | 2088P0231X | Pediatric Urologist | 4022 | ND |
NPI | 1023049129 |
---|---|
Provider Name | Conrad R Toni |
First Address | Fargo, ND 58102-3641 |
Second Address | Fargo, ND 58102-3641 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/07/2006 |
Last Update Date | 16/12/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
D64069 | (02) |