NPI 1023282969

Tracie M Mallberg MD PC

Organisation Primary Care Clinic/Center West Fargo, ND

Practice location

Address: 550 13th Ave E, West Fargo, ND 58078-3360
Phone: (701) 356-5459
Fax: (701) 356-3764

Authorised official

Name: Tracie M Mallberg
Title: President
Phone: (701) 356-5459

Registered specialties

Primary Care Clinic/Center Primary

Ambulatory Health Care Facilities Taxonomy 261QP2300X Licence 9395 (ND)

Other Clinic/Center providers in North Dakota →

Registry record

NPI: 1023282969
Entity type: Organization
NPI issued: 22 Apr 2008
Record last updated: 1 Aug 2008

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.