Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208200000X | Surgeon | 11005 | ND |
N | 208600000X | Surgeon | 11005 | ND |
N | 208200000X | Surgeon | 41191 | WI |
N | 208600000X | Surgeon | 41191 | WI |
Y | 2086S0102X | Surgical Critical Care | 41191 | WI |
N | 2086S0120X | Pediatric Surgery | 1105 | ND |
N | 2086S0127X | Trauma Surgeon | 11005 | ND |
NPI | 1184725921 |
---|---|
Provider Name | Randolph Eugene Szlabick |
First Address | Grand Forks, ND 58206-6002 |
Second Address | Grand Forks, ND 58206-6002 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/09/2006 |
Last Update Date | 24/09/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
32561500 | (05) | WI |
B29420 | (02) |