Individual
DOUGLAS A ROISE
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
PO BOX 6001, FARGO, ND 58108-6001
(701) 364-3300
(701) 364-8906
Taxonomy
Speciality
Code
Description
License number
State
207ZP0105X
Clinical Pathology/Laboratory Medicine Physician
Primary
4957
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1012767
ARAZ #
ND
01
—
1100119
FGO MEDICA #
ND
01
—
1100125
INN MEDICA #
ND
01
—
12352
SIOUX VALLEY #
ND
01
—
142059
UCARE #
ND
05
—
14544
—
ND
05
—
17475
—
ND
01
—
19107
FGO NDBS #
ND
05
—
213627900
—
ND
01
—
88D16RO
FGO MNBS#
ND
01
—
DA9011026994
PREF 1 #
ND
01
—
HP38337
HEALTHPARTNERS #
ND
Enumeration date
07/18/2006
Last updated
07/18/2012
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