Individual
TODD DUPPONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
5225 23RD AVE S, FARGO, ND 58104-7927
(701) 417-2100
Mailing address
PO BOX 2010, FARGO, ND 58122-2484
(701) 417-2100
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
15616
ND
207P00000X
Emergency Medicine Physician
65724
MN
Other
Enumeration date
04/13/2016
Last updated
10/01/2019
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