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Contact Information

PAUL M DITMANSON, MD
HWY 1 BOX 497
PHS INDIAN HOSPITAL
RED LAKE, MN56671
 Phone: 218-679-3912
 Fax: 218-679-0181
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Family Medicine

207Q00000X 08 Physician/Family Practice
Indicates primary specialty

NPI Profile & details for PAUL M DITMANSON · (Male)

NPI # 1922181676
Status Active
Credentials MD
Entity Individual
Enumeration date 10/23/2006
Last updated 11/08/2007 - About 19 years ago
Sole proprietor 1 Yes
Identifiers
  • MN License # 30915
  • MN Medicaid 476753500
  • MN Other 30915 MINNESOTA LICENSE
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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