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NPI Code Detail

MEDICARE: JON D DANGERFIELD MD

MEDICARE: JON D DANGERFIELD MD
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
1207V00000XObstetrics & Gynecology Physician7503ND

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1245258896
Entity Type Code : Individual
Provider Name (Legal Business Name) : JON D DANGERFIELD MD
Provider Business Mailing Address
First Line : 1220 SHEYENNE ST
Second Line :
City : WEST FARGO
State : ND
Zip : 58078-2637
Country : US
Telephone Number : 701-234-4445
Fax Number : 701-234-4385
Provider Business Practice Location Address
First Line : 1220 SHEYENNE ST
Second Line :
City : WEST FARGO
State : ND
Zip : 58078-2637
Country : US
Telephone Number : 701-234-4445
Fax Number : 701-234-4385
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/18/2006
Last Update Date : 04/08/2013

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