Healthcare Provider Details

I. General information

NPI: 1659398329
Provider Name (Legal Business Name): NATHAN L KOBRINSKY MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/17/2006
Last Update Date: 06/23/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2101 ELM STREET N
FARGO ND
58102
US

IV. Provider business mailing address

2101 ELM STREET N
FARGO ND
58102
US

V. Phone/Fax

Practice location:
  • Phone: 701-239-3700
  • Fax: 701-234-3861
Mailing address:
  • Phone: 701-239-3700
  • Fax: 701-234-3861

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080P0207X
TaxonomyPediatric Hematology & Oncology Physician
License Number6219
License Number StateND

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: