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NPI Code Detail

MEDICARE: DOUGLAS D BERGLUND MD

MEDICARE: DOUGLAS D BERGLUND 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
1208600000XSurgery Physician7018ND
2208C00000XColon & Rectal Surgery PhysicianMED-PHYS-LIC-132495MT

Other Identifiers

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

General Provider Information

NPI Number : 1396708418
Entity Type Code : Individual
Provider Name (Legal Business Name) : DOUGLAS D BERGLUND MD
Provider Business Mailing Address
First Line : PO BOX 5501
Second Line :
City : BISMARCK
State : ND
Zip : 58506-5501
Country : US
Telephone Number : 701-323-6000
Fax Number : 701-323-5709
Provider Business Practice Location Address
First Line : 1333 SURGICAL SERVICES WAY
Second Line :
City : KALISPELL
State : MT
Zip : 59901-4844
Country : US
Telephone Number : 406-751-5392
Fax Number : 406-751-5406
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/10/2006
Last Update Date : 04/18/2025

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