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Tracie M Mallberg Md Pc
Primary Care Clinic/Center in West Fargo, North Dakota
NPI 1023282969

Tracie M Mallberg Md Pc is a Primary Care Clinic/Center based in West Fargo, ND and is specialized in Primary Care. Tracie M Mallberg Md Pc practices in West Fargo, ND. The NPI Number for Tracie M Mallberg Md Pc is 1023282969 and holds a License No. 9395 (North Dakota).

The current practice location address for Tracie M Mallberg Md Pc is 550 13Th Ave E, West Fargo, ND and can be reached out via phone at 701-356-5459 and via fax at 701-356-3764.

Location: 550 13Th Ave E, West Fargo, ND, 58078-3360
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1023282969
Provider Name
Tracie M Mallberg Md Pc
Credential
Provider Entity Type
Organization
Address
550 13Th Ave E, West Fargo, ND, 58078-3360
Phone Number
701-356-5459
Fax Number
701-356-3764
Provider Enumeration Date
04/22/2008
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
14788 05 ND
institution
Provider Business Practice Location Address Details
Address
550 13Th Ave E
City
West Fargo
State
North Dakota
Zip
58078-3360
Phone Number
701-356-5459
Fax Number
701-356-3764
person
Provider Business Mailing Address Details
Address
550 13Th Ave E
City
West Fargo
State
North Dakota
Zip
58078-3360
Phone Number
701-356-5459
Fax Number
701-356-3764
person
Provider's Taxonomy Details 1
Type
Ambulatory Health Care Facilities
Classification
Clinic/Center
Speciality
Primary Care
Taxonomy
261QP2300X
License No.
9395 (North Dakota)
Definition
Definition to come...
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