Provider Demographics
NPI:1619991254
Name:DRAMKO, JOSEPH GEORGE (MD)
Entity Type:Individual
Prefix:
First Name:JOSEPH
Middle Name:GEORGE
Last Name:DRAMKO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:828 KIRKWOOD MALL
Mailing Address - Street 2:MID DAKOTA CLINIC
Mailing Address - City:BISMARCK
Mailing Address - State:ND
Mailing Address - Zip Code:58504-5753
Mailing Address - Country:US
Mailing Address - Phone:701-530-6000
Mailing Address - Fax:701-530-6469
Practice Address - Street 1:828 KIRKWOOD MALL
Practice Address - Street 2:MID DAKOTA CLINIC
Practice Address - City:BISMARCK
Practice Address - State:ND
Practice Address - Zip Code:58504-5753
Practice Address - Country:US
Practice Address - Phone:701-530-6000
Practice Address - Fax:701-530-6469
Is Sole Proprietor?:No
Enumeration Date:2006-07-27
Last Update Date:2017-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WY7382A208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
WY314169OtherBLUE CROSS
WY122755600OtherWY MEDICAID
WY122755600Medicaid