Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Q00000X | Family Doctor | 16509 | ND |
N | 207Q00000X | Family Doctor | 300099 | NY |
N | 207VX0000X | Obstetrician | 16509 | ND |
NPI | 1154776268 |
---|---|
Provider Name | Ines A Teuma Nguimfack |
First Address | Williston, ND 58801-3821 |
Second Address | Williston, ND 58801-3800 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/04/2016 |
Last Update Date | 09/06/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1480547 | (05) | ND |