Healthcare Provider Details

I. General information

NPI: 1366470601
Provider Name (Legal Business Name): DAVID T BJORK M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/28/2006
Last Update Date: 02/15/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

712 SOUTH CASCADE STREET
FERGUS FALLS MN
56537-2813
US

IV. Provider business mailing address

712 SOUTH CASCADE STREET
FERGUS FALLS MN
56537-2813
US

V. Phone/Fax

Practice location:
  • Phone: 218-736-8000
  • Fax: 218-739-6742
Mailing address:
  • Phone: 218-736-8000
  • Fax: 218-739-6742

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number25165
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: