Most Relevant Information
Provider Data
| NPI Number: | 1003802430 |
| Provider Name: | ANTHONY KEVIN MUIDERMAN MD |
| Entity Type: | Individual |
| Taxonomy Code: | 208200000X |
| Specialty: | Plastic Surgery |
| License Number: | 10458 |
Most Important Dates
| Enumeration Date: | 09/21/2005 |
| Last Updated: | 02/26/2019 |
Provider Practice Location
3165 DEMERS AVE - TRUYU AESTHETIC CENTER
GRAND FORKS
ND
58201
Practice Location Phone/Fax
| Phone: | 7017806623 |
| Fax: |
Provider Mailing Location
2401 DEMERS AVE
GRAND FORKS
ND
58201
Provider Mailing Phone/Fax
| Phone: | 7017801891 |
| Fax: | 7017801942 |