Dr. R Twardowski MD PC

Primary specialty

Case Manager/Care CoordinatorTaxonomy code 171M00000X

License

6950 Issued in ND

Legal business name

DR. R TWARDOWSKI MD PC

Practice address

1842 14TH St S Apt 4
Fargo, ND 58103-4842

Phone

(701) 220-1970

NPI assigned

Nov 19, 2012

Last updated

Nov 26, 2012By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Radomysl Marian Twardowski, M.D.

Title

Ceo

Phone

(701) 220-1970

Specialties & licenses 1

Addresses

Other identifiers 1

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1353283200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1353888000000",
    "number": "1053655795",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1842 14TH ST S APT 4",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581034842",
            "telephone_number": "701-220-1970"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1842 14TH ST S APT 4",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581034842",
            "telephone_number": "701-220-1970"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR. R TWARDOWSKI MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-11-19",
        "last_updated": "2012-11-26",
        "status": "A",
        "authorized_official_last_name": "TWARDOWSKI",
        "authorized_official_first_name": "RADOMYSL",
        "authorized_official_middle_name": "MARIAN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "701-220-1970",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "ND",
            "license": "6950",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "18001",
            "state": "ND"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 26, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.