Basic Information
| Provider Information | |||||||||
| NPI: | 1639113749 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | CZARNIK | ||||||||
| FirstName: | TAMARACK | ||||||||
| MiddleName: | ROBERT | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 307 | ||||||||
| Address2: | |||||||||
| City: | MCVILLE | ||||||||
| State: | ND | ||||||||
| PostalCode: | 582540307 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7013224347 | ||||||||
| FaxNumber: | 7013222244 | ||||||||
| Practice Location | |||||||||
| Address1: | 108 NORTH MAIN STREET | ||||||||
| Address2: | |||||||||
| City: | MCVILLE | ||||||||
| State: | ND | ||||||||
| PostalCode: | 582540307 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7013224347 | ||||||||
| FaxNumber: | 7013222244 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/16/2006 | ||||||||
| LastUpdateDate: | 10/29/2009 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | 5243A | WY | N | Allopathic & Osteopathic Physicians | Family Medicine | 207Q00000X | 7329 | ND | Y | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.