Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207SG0201X | Clinical Genetics (M.D.) | 34027 | MN |
NPI | 1356311898 |
---|---|
Provider Name | Pamela S Mcgrann |
First Address | Fargo, ND 58122-2484 |
Second Address | Fargo, ND 58102-3641 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/01/2006 |
Last Update Date | 11/01/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
686818500 | (05) | MN |
E24195 | (02) |