Provider Demographics
NPI:1326235631
Name:DR. NICHOLAS NEUMANN
Entity Type:Organization
Organization Name:DR. NICHOLAS NEUMANN
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR CODING/BILLING
Authorized Official - Prefix:MRS
Authorized Official - First Name:SHAWNA
Authorized Official - Middle Name:D
Authorized Official - Last Name:ZASTOUPIL
Authorized Official - Suffix:
Authorized Official - Credentials:RHIT
Authorized Official - Phone:701-323-9900
Mailing Address - Street 1:300 W CENTURY AVE
Mailing Address - Street 2:
Mailing Address - City:BISMARCK
Mailing Address - State:ND
Mailing Address - Zip Code:58503-1401
Mailing Address - Country:US
Mailing Address - Phone:701-323-9900
Mailing Address - Fax:701-323-9911
Practice Address - Street 1:300 W CENTURY AVE
Practice Address - Street 2:
Practice Address - City:BISMARCK
Practice Address - State:ND
Practice Address - Zip Code:58503-1401
Practice Address - Country:US
Practice Address - Phone:701-323-9900
Practice Address - Fax:701-323-9911
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-01
Last Update Date:2008-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND4411207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NDP00260202OtherMEDICARE RAIL ROAD
ND013643Medicaid
ND4411OtherND LICENSE #
NDD26169OtherUPIN
ND013643Medicaid
ND013643Medicaid