Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 111N00000X | Chiropractor | 758 | ND |
N | 111NN0400X | Neurology | 758 | ND |
NPI | 1578642781 |
---|---|
Provider Name | Dr. Charles Charles Sefcik |
First Address | Bismarck, ND 58503-0518 |
Second Address | Bismarck, ND 58501-1931 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/11/2006 |
Last Update Date | 09/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
V03941 | (02) | ND |