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NPI 1407850225

NPI 1407850225 : JON DAVID NORBERG M.D. : MAPLE GROVE, MN

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General NPI Number Information
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    NPI Number           |    1407850225
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    Entity Type          |    Individual 
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    Provider Name        |    JON DAVID NORBERG M.D.
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    06/09/2005
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    Last Update Date     |    10/30/2024
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Provider Practice Location Address
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    Address Line         |    9325 UPLAND LN N STE 255 
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    City                 |    MAPLE GROVE
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    State                |    MN
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    Zip                  |    55369-4463
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    Country              |    US
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    Telephone            |    763-465-4263
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    Fax                  |    763-314-2026
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Provider Business Mailing Address
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    Address Line         |    9325 UPLAND LN N STE 255 
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    City                 |    MAPLE GROVE
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    State                |    MN
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    Zip                  |    55369-4463
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    Country              |    US
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    Telephone            |    763-465-4263
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    Fax                  |    763-314-2026
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    207X00000X
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    Taxonomy Name        |    Orthopaedic Surgery Physician
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    License Number       |    9161
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    License Number State |    ND
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Taxonomy #2
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    Taxonomy Code        |    2086S0105X
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    Taxonomy Name        |    Surgery of the Hand (Surgery) Physician
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    License Number       |    9161
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    License Number State |    ND
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Taxonomy #3
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    Taxonomy Code        |    2086S0105X
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    Taxonomy Name        |    Surgery of the Hand (Surgery) Physician
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    License Number       |    63419
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    License Number State |    MN
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Taxonomy #4
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    Taxonomy Code        |    207X00000X
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    Taxonomy Name        |    Orthopaedic Surgery Physician
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    License Number       |    63419
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    License Number State |    MN
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Taxonomy #5
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    Taxonomy Code        |    207XS0106X
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    Taxonomy Name        |    Orthopaedic Hand Surgery Physician
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    License Number       |    63419
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    License Number State |    MN
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