Most Relevant Information
Provider Data
| NPI Number: | 1003076894 |
| Provider Name: | JASON C MYRMOE MD |
| Entity Type: | Individual |
| Taxonomy Code: | 390200000X |
| Specialty: | Student in an Organized Health Care Education/Training Program |
| License Number: | 0116019619 |
Most Important Dates
| Enumeration Date: | 06/15/2008 |
| Last Updated: | 01/12/2024 |
Provider Practice Location
2400 32ND AVE S
FARGO
ND
581035800
Practice Location Phone/Fax
| Phone: | 7012348779 |
| Fax: |
Provider Mailing Location
PO BOX 5074
SIOUX FALLS
SD
571175074
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |