Individual
MARK D ROSTAD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3000 32ND AVE S, FARGO, ND 58103-6132
(701) 364-8000
Mailing address
1702 UNIVERSITY DR S, FARGO, ND 58103-4940
(701) 364-8000
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
69877
WI
207RH0002X
Hospice and Palliative Medicine (Internal Medicine) Physician
Primary
PT17670
ND
208M00000X
Hospitalist Physician
PT17670
ND
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/29/2016
Last updated
08/09/2021
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