Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XS0106X | Orthopaedic Hand Surgeon | 3512 | ND |
NPI | 1184641656 |
---|---|
Provider Name | J Donald Opgrande |
First Address | Fargo, ND 58103-5800 |
Second Address | Fargo, ND 58103-6104 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 17/07/2006 |
Last Update Date | 16/09/2009 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
D26192 | (02) |