Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0203X | Pediatric Critical Care Doctor | 11335 | ND |
N | 2080P0203X | Pediatric Critical Care Doctor | MD00031504 | WA |
NPI | 1184688772 |
---|---|
Provider Name | John Alan Paschall |
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 | 12/04/2006 |
Last Update Date | 27/04/2012 |