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| Type | Legal entity | [sources] | |||
|---|---|---|---|---|---|
| Name | Gonzalez, Angel | [sources] | |||
| Legal form | not available | [sources] | |||
| Country | United States | [sources] | |||
| Description | Medicaid Provider ID: 1487373 | [sources] | |||
| NPI | 1508444993 | [sources] | |||
| Sector | Qualified Service Provider | [sources] | |||
| Status | not available | [sources] | |||
| Address | PO Box 20 Bowdon, ND 58418 | [sources] | |||
| Last change | Last processed | First seen | |||
This dataset contains a list of providers who have been terminated for cause from North Dakota's Medicaid program.
United States of America · NDHHS
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