NPI 1861016024

Ezra Koch, MD

Practitioner General Practice Physician Mandan, ND

Practice location

Address: 4108 39th Ave NW, Mandan, ND 58554-1253
Phone: (701) 426-4291

Registered specialties

General Practice Physician Primary

Allopathic & Osteopathic Physicians Taxonomy 208D00000X Licence 19404 (ND)

Other General Practice providers in North Dakota →

Registry record

NPI: 1861016024
Entity type: Individual
Sex (as registered): Male
NPI issued: 3 Jun 2020
Record last updated: 1 Mar 2023

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.