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General NPI Number Information
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NPI Number | 1043397870
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Entity Type | Organization
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Legal Business Name | NORTHLAND OB-GYN ASSOCIATES
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Dates
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Enumeration Date | 11/01/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1000 E 1ST ST STE LL
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City | DULUTH
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State | MN
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Zip | 55805-2297
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Country | US
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Telephone | 218-722-5629
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Fax | 218-722-5148
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Provider Business Mailing Address
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Address Line | 1000 E 1ST ST STE LL
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City | DULUTH
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State | MN
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Zip | 55805-2297
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Country | US
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Telephone | 218-722-5629
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Fax | 218-722-5148
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Authorized Official
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Title or Position | PARTNER
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Name | JAMES A SEBASTIAN
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Credential | MD
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Telephone | 218-722-5629
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM2500X
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Taxonomy Name | Medical Specialty Clinic/Center
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License Number |
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License Number State |
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