Stephanie Moore Canham, M.D.
Internal Medicine in Bismarck, ND. Individual provider (NPI-1).
NPI number1457614729
StatusActive
Last updated in NPPESJul 21, 2022
Details
- NPI
- 1457614729
- Entity type
- Individual (NPI-1)
- Name
- Stephanie Moore Canham
- Credential
- M.D.
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Jun 20, 2012
- Certification date
- Mar 2, 2020
- Last updated
- Jul 21, 2022
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207R00000X | Internal Medicine | PT14735 | ND | Yes |
| 207R00000X | Internal Medicine | 2012018498 | MO |
Practice location
209 N 7th StBismarck, ND 58501-4441
Phone 701-323-5590
Mailing address
Po Box 5074Sioux Falls, SD 57117-5074
Phone 605-328-9541
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