Individual
WILLIAM GREGORY LAMMLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
801 BROADWAY N, FARGO, ND 58102-3641
(701) 234-2576
(701) 234-3769
Mailing address
801 BROADWAY N, FARGO, ND 58102-3641
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PAC0053
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
266905600
—
MN
05
—
71083
—
ND
Enumeration date
07/17/2006
Last updated
10/17/2012
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