Individual
DR. A MARC NIELSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
725 HAMLINE ST, GRAND FORKS, ND 58203-2819
(701) 780-6800
(701) 780-4391
Mailing address
PO BOX 6002, GRAND FORKS, ND 58206-6002
(701) 780-5000
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
8011
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
10969
—
ND
01
—
19474
BLUE CROSS OF ND
ND
Enumeration date
07/17/2006
Last updated
07/10/2020
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