Individual
MR. JOHN MICHAEL TATE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1702 UNIVERSITY DR S, FARGO, ND 58103-4940
(701) 364-3300
(701) 364-8906
Mailing address
400 E 3RD ST, DULUTH, MN 55805-1951
Taxonomy
Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
44110
MN
207RX0202X
Medical Oncology Physician
Primary
8586
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
11355
—
ND
05
—
909685000
—
MN
Enumeration date
07/24/2006
Last updated
03/10/2020
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