Provider Demographics
NPI:1851309579
Name:NORIDIAN MUTUAL INSURANCE COMPANY
Entity Type:Organization
Organization Name:NORIDIAN MUTUAL INSURANCE COMPANY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT & CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:UNHJEM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:701-282-1100
Mailing Address - Street 1:4510 13TH AVE S
Mailing Address - Street 2:
Mailing Address - City:FARGO
Mailing Address - State:ND
Mailing Address - Zip Code:58121-1000
Mailing Address - Country:US
Mailing Address - Phone:701-282-1100
Mailing Address - Fax:701-282-1109
Practice Address - Street 1:4510 13TH AVE S
Practice Address - Street 2:
Practice Address - City:FARGO
Practice Address - State:ND
Practice Address - Zip Code:58121-1000
Practice Address - Country:US
Practice Address - Phone:701-282-1100
Practice Address - Fax:701-282-1109
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-05
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered302F00000XManaged Care OrganizationsExclusive Provider Organization
Not Answered302R00000XManaged Care OrganizationsHealth Maintenance Organization
Not Answered305R00000XManaged Care OrganizationsPreferred Provider Organization
Not Answered305S00000XManaged Care OrganizationsPoint of Service