Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Ezra Koch, MD

Individual provider General Practice Physician · NPI 1861016024

Ezra Koch, MD is a General Practice Physician in Mandan, North Dakota. Practices as a sole proprietor. Licensed in North Dakota.

Licensed in
ND
In the registry since
2020
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

4108 39th Ave NW
Mandan, ND 58554-1253
Phone: (701) 426-4291
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

General Practice Physician (primary) Taxonomy 208D00000X · Licence 19404 (ND)

Record details

NPI number1861016024
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorYes
NPI enumeratedJune 3, 2020
Last updated in NPPESMarch 1, 2023
Certification dateMarch 1, 2023
Mailing address4108 39th Ave Nw, Mandan, ND 58554-1253

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