Jeremy Forrest Brudevold D.O.

NPI 1699094748 - Student in an Organized Health Care Education/Training Program - 390200000X

NPI Details
NPI 1699094748
Gender Male
Enumeration Date 05/27/2010
Last Updated 07/15/2013
Entity Type Individual
Active Over 6 years ago
Practice Location
801 BROADWAY N
FARGO ND, 58102-3641, US
Phone (701) 234-5121
Fax
Business Location
801 BROADWAY N
FARGO ND, 58102-3641, US
Phone (701) 234-5121
Fax
Toxanomy
Taxonomy Code 390200000X
License State
License Number
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According to our database, Dr. Jeremy Forrest Brudevold D.O. NPI is 1699094748, taxonomy code is 390200000X Jeremy Forrest Brudevold D.O. physically located at 801 Broadway N, Fargo ND, 58102-3641. NPI Number Jeremy Forrest Brudevold D.O. has the Individual type.

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1699094748 NPI number is provided on an as is basis without warranty of any kind. 1699094748 is maintained by the National Plan & Provider Enumeration System. The contents of Jeremy Forrest Brudevold D.O. are for informational purposes only.