Provider Demographics
NPI:1861149452
Name:SISA, EUNICE ANIMWAA (MD)
Entity type:Individual
Prefix:DR
First Name:EUNICE
Middle Name:ANIMWAA
Last Name:SISA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:EUNICE
Other - Middle Name:ANIMWAA
Other - Last Name:BOADI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 5010
Mailing Address - Street 2:
Mailing Address - City:MINOT
Mailing Address - State:ND
Mailing Address - Zip Code:58702-5010
Mailing Address - Country:US
Mailing Address - Phone:701-418-8000
Mailing Address - Fax:
Practice Address - Street 1:2305 37TH AVE SW
Practice Address - Street 2:
Practice Address - City:MINOT
Practice Address - State:ND
Practice Address - Zip Code:58701-7669
Practice Address - Country:US
Practice Address - Phone:701-418-8000
Practice Address - Fax:701-418-3444
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-03
Last Update Date:2025-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
ND22006208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program