Individual
CRAIG BACKOUS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
2101 ELM ST N, FARGO, ND 58102-2417
(701) 239-3700
Mailing address
2101 ELM ST N, FARGO, ND 58102-2417
(701) 239-3700
(701) 237-2653
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
036123981
IL
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
036.123981
IL
207RP1001X
Pulmonary Disease Physician
Primary
036123981
IL
Other
Enumeration date
07/24/2007
Last updated
02/25/2025
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