Provider Demographics
NPI:1033845243
Name:RVISION HEALTH OF NORTH DAKOTA PC
Entity Type:Organization
Organization Name:RVISION HEALTH OF NORTH DAKOTA PC
Other - Org Name:RVISION HEALTH PC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF MEDICAL OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:MATT
Authorized Official - Middle Name:
Authorized Official - Last Name:MESNIK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:763-670-4265
Mailing Address - Street 1:706 38TH STREET NW
Mailing Address - Street 2:UNIT A
Mailing Address - City:FARGO
Mailing Address - State:ND
Mailing Address - Zip Code:58102-1618
Mailing Address - Country:US
Mailing Address - Phone:877-893-4792
Mailing Address - Fax:
Practice Address - Street 1:706 38TH ST NW STE A
Practice Address - Street 2:
Practice Address - City:FARGO
Practice Address - State:ND
Practice Address - Zip Code:58102-2953
Practice Address - Country:US
Practice Address - Phone:877-893-4792
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-07-29
Last Update Date:2022-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care