Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207T00000X | Neurosurgeon | 10239 | ND |
NPI | 1043227630 |
---|---|
Provider Name | Dr. Steven G Kraljic |
First Address | Bismarck, ND 58502-0997 |
Second Address | Bismarck, ND 58501-4515 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/08/2006 |
Last Update Date | 20/12/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1452877 | (05) | ND |
I60282 | (02) |