Individual provider · NPI-1

Dr. Andrew M Bakken, MD

· Fargo, ND

NPI number1376648113
StatusActive
Last updated in NPPESMar 29, 2024

Details

NPI
1376648113
Entity type
Individual (NPI-1)
Name
Dr. Andrew M Bakken
Credential
MD
Sex
Male
Sole proprietor
No
Enumeration date
Sep 14, 2006
Certification date
Mar 29, 2024
Last updated
Mar 29, 2024

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
2086S0129X 12336NDYes
2086S0129X 104929MN
2086S0129X 53267MN
390200000X Student in an Organized Health Care Education/Training Program––

Practice location

801 Broadway N
Fargo, ND 58102-3641

Phone 701-234-2000

Mailing address

Po Box 5074
Sioux Falls, SD 57117-5074

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