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Ezra Koch, MD
General Practice Physician in Mandan, North Dakota
NPI 1861016024

Ezra Koch is a General Practice Physician based in Mandan, ND. Ezra Koch practices in Mandan, ND and has the professional credentials of MD. The NPI Number for Ezra Koch is 1861016024 and holds a License No. 19404 (North Dakota).

The current practice location address for Ezra Koch is 4108 39Th Ave Nw, Mandan, ND and can be reached out via phone at 701-426-4291.

Location: 4108 39Th Ave Nw, Mandan, ND, 58554-1253
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1861016024
Provider Name
Ezra Koch
Credential
MD
Provider Entity Type
Individual
Gender
Male
Address
4108 39Th Ave Nw, Mandan, ND, 58554-1253
Phone Number
701-426-4291
Fax Number
Provider Enumeration Date
06/03/2020
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
4108 39Th Ave Nw
City
Mandan
State
North Dakota
Zip
58554-1253
Phone Number
701-426-4291
Fax Number
person
Provider Business Mailing Address Details
Address
4108 39Th Ave Nw
City
Mandan
State
North Dakota
Zip
58554-1253
Phone Number
701-426-4291
Fax Number
person
Provider's Taxonomy Details 1
Type
Allopathic & Osteopathic Physicians
Classification
General Practice
Speciality
-
Taxonomy
208D00000X
License No.
19404 (North Dakota)
Definition
Definition to come...
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