Healthcare Provider Details

I. General information

NPI: 1972682532
Provider Name (Legal Business Name): NAPOLEON R ESPEJO MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/03/2006
Last Update Date: 03/25/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

301 NP AVE N
FARGO ND
58102-4835
US

IV. Provider business mailing address

PO BOX 2625
FARGO ND
58108-2625
US

V. Phone/Fax

Practice location:
  • Phone: 701-271-3344
  • Fax: 701-271-3343
Mailing address:
  • Phone: 701-271-3344
  • Fax: 701-271-3347

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number8008
License Number StateND
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number40268
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: