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NPI Code Detail

MEDICARE: MR. IAN RICHARD ALSGAARD APRN

MEDICARE: MR. IAN RICHARD ALSGAARD APRN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LA2200XAdult Health Nurse PractitionerL1075750MI

General Provider Information

NPI Number : 1245213792
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. IAN RICHARD ALSGAARD APRN
Provider Business Mailing Address
First Line : 700 COOPER AVE
Second Line :
City : SAGINAW
State : MI
Zip : 48602-5383
Country : US
Telephone Number : 989-583-6685
Fax Number : 989-583-6088
Provider Business Practice Location Address
First Line : 700 COOPER AVE
Second Line :
City : SAGINAW
State : MI
Zip : 48602-5383
Country : US
Telephone Number : 989-583-6685
Fax Number : 989-583-6088
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/29/2005
Last Update Date : 08/03/2007

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