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Organization
LASER & SURGERY CENTER, LLC
Active
Organization
LASER & SURGERY CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STEVEN M BAGAN M.D. (OWNER)
(701) 293-8242
Entity
Organization
Contact information
Practice address
4344 20TH AVE S, FARGO, ND 58103-4434
(701) 293-8242
(701) 293-0909
Mailing address
4344 20TH AVE S, FARGO, ND 58103-4434
(701) 293-8242
(701) 293-0909
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1114047230
RAILROAD MEDICARE
ND
05
—
11661
—
ND
01
—
2C12LA
MN BS
MN
05
—
634794110
—
MN
01
—
6800026
MEDICA
ND
Enumeration date
03/30/2007
Last updated
08/01/2008
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