Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RC0000X | Internist - Cardiovascular Disease | 10359 | ND |
N | 207RC0000X | Internist - Cardiovascular Disease | LT10359 | ND |
NPI | 1003923780 |
---|---|
Provider Name | Nicholas C Mahr |
First Address | Bismarck, ND 58501-4516 |
Second Address | Bismarck, ND 58501-4516 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/08/2006 |
Last Update Date | 25/05/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
13910 | (05) | ND |
F22894 | (02) | ND |