Individual
DR. UTPAL U CHAKRAVORTY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1282 WALNUT ST, DAWSON, MN 56232-2333
(320) 312-2118
(320) 769-2972
Mailing address
PO BOX 6001, FARGO, ND 58108-6001
(701) 364-6600
(701) 364-6628
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
38604
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
909316800
—
MN
Enumeration date
06/25/2006
Last updated
11/05/2019
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