Alexander Shatalov, PHARMD
Individual provider Active NPI Pharmacist · Bowman, ND
NPI 1023638178 · NPPES record last updated Oct 16, 2025
Key facts
- NPI
- 1023638178
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 29102 (NC)
- Practice address
- 802 2ND St NW
Bowman, ND 58623-4483 - Phone
- (701) 523-7178
- NPI assigned
- Apr 19, 2020
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 29102 | NC | MD | Addiction (Substance Use Disorder) Counselor |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 29102 | NC | Yes |
Addresses
Primary practice location
802 2ND St NW
Bowman, ND 58623-4483
Mailing address
802 2ND St NW
Bowman, ND 58623-4483
Phone (701) 523-7178
Other providers in Bowman, ND
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 16, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.