Basic Information
Provider Information
NPI: 1700899580
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: ALAKECH
FirstName: BADIE
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: MD
OtherOrganizationName:  
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OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 5010
Address2:  
City: MINOT
State: ND
PostalCode: 587025010
CountryCode: US
TelephoneNumber: 7018575650
FaxNumber: 7018575031
Practice Location
Address1: 1 BURDICK EXPY W
Address2:  
City: MINOT
State: ND
PostalCode: 587014406
CountryCode: US
TelephoneNumber: 7018575214
FaxNumber: 7018575021
Other Information
ProviderEnumerationDate: 08/14/2006
LastUpdateDate: 05/02/2014
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207ZP0102XMD2004-0577NMN Allopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
207ZB0001XMD2004-0577NMN Allopathic & Osteopathic PhysiciansPathologyBlood Banking & Transfusion Medicine
207ZP0102X11090NDY Allopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology

No ID Information.


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