Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208200000X | Surgeon | 14813 | ND |
N | 208600000X | Surgeon | 14813 | ND |
N | 208200000X | Surgeon | MD446591 | PA |
N | 208600000X | Surgeon | MD446591 | PA |
Y | 2086S0102X | Surgical Critical Care | 14813 | ND |
N | 2086S0102X | Surgical Critical Care | C160683 | CA |
NPI | 1154594919 |
---|---|
Provider Name | Dr. Karin M Mcconville |
First Address | Grand Forks, ND 58201 |
Second Address | Grand Forks, ND 58201 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/04/2008 |
Last Update Date | 22/09/2020 |