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Contact Information

PAMELA M ANTONIUK, MD
3000 32ND AVE S
FARGO, ND58103-6132
 Phone: 701-364-8000
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Plastic Surgery

208200000X 02 Physician/General Surgery
Indicates primary specialty

NPI Profile & details for PAMELA M ANTONIUK · (Female)

NPI Number 1366513970
Status Active
Credentials MD
Entity Individual
Enumeration date 11/13/2006
Last updated 12/24/2015 - About 10 years ago
Sole proprietor 1 No
Identifiers
  • ND License # 11656
  • MN Medicaid 1366513970
  • ND Medicaid 15402
  • RI Medicaid 9020306
Hospital affiliation(s)
  • ESSENTIA HEALTH-FARGO - (Acute Care)
    3000 32ND AVE SOUTH
    FARGO, ND 58104
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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