Douglas Mai

Individual provider Active NPI Diagnostic Radiology Physician · New Town, ND

NPI 1124511415 · NPPES record last updated Jun 11, 2018

Key facts

NPI
1124511415
Entity type
Individual (NPI type 1)
Primary specialty
Diagnostic Radiology Physician 2085R0202X
License
935 (ND)
Practice address
1058 College Dr
New Town, ND 58763-9112
Phone
(701) 627-7681
NPI assigned
Jun 11, 2018
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

State licenses

LicenseStateTypeSpecialty
935NDMDDiagnostic Radiology Physician

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 935 ND Yes

Addresses

Primary practice location

1058 College Dr
New Town, ND 58763-9112

Mailing address

1058 College Dr
New Town, ND 58763-9112

Other providers in New Town, ND

All providers in New Town, ND · Diagnostic Radiology Physician in North Dakota

Sources for this page

Verify at the official NPI Registry.