ProviderBusinessMailingAddressFaxNumber = '7017806974'
NPI
LastName
FirstName
MidName
Organization
Mailing Address
City
State
Zip
1942307723
BREITWIESER
WAYNE
R
 
2401 DEMERS AVE
GRAND FORKS
ND
58201
1710047600
MUDIREDDY
UMAMAHESWARA
R
 
2401 DEMERS AVE
GRAND FORKS
ND
58201
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