Podrygula, Stephan

Podrygula, Stephan is an individual health care provider with primary practice located at 600 22Nd Ave Nw Northland Professional Building, Minot ND 58703-0986. He recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as his primary health care specialty. Podrygula, Stephan can be contacted via phone (701) 852-9113.

Contact Information

Primary practice address
600 22Nd Ave Nw Northland Professional Building Minot ND 58703-0986
Phone: (701) 852-9113
Fax: (701) 838-0779
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 103TC0700X 136 North Dakota

Profile Details

NPI number 1205821527
LBN Legal business name Podrygula, Stephan
Credentials PH.D.
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 13th, 2005
Last updated Feb 27th, 2009 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1205821527 NPPES
North Dakota Other POD5241 BLUE CROSS BLUE SHIELD
North Dakota MEDICAID 16946 BLUE CROSS BLUE SHIELD

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