Individual
DAVID B EBERLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
4700 S WASHINGTON ST STE G, GRAND FORKS, ND 58201-8123
(701) 205-3000
(701) 732-2501
Mailing address
PO BOX 5210, GRAND FORKS, ND 58206-5210
(701) 205-3000
(701) 732-2501
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
12819
MN
363A00000X
Physician Assistant
PA10003354
WA
363A00000X
Physician Assistant
Primary
PAC0596
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1465113
—
ND
05
—
8349425
—
WA
Enumeration date
02/13/2006
Last updated
01/06/2020
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