Individual
DANIEL G MICKELSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
737 BROADWAY, FARGO, ND 58122-0001
(701) 234-2000
(701) 234-7332
Mailing address
PO BOX 5074, SIOUX FALLS, SD 57117-5074
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
5819
ND
2085R0204X
Vascular & Interventional Radiology Physician
Primary
5819
ND
Other
Enumeration date
07/17/2006
Last updated
02/22/2022
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