Individual
STEFANIE S GEFROH ELLISON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
3000 32ND AVE S, FARGO, ND 58103-6132
(701) 364-8000
(701) 364-8078
Mailing address
PO BOX 6001, FARGO, ND 58108-6001
(701) 364-8000
(701) 364-8078
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
9688
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0704093
MEDICA #
ND
01
—
0704094
MEDICA #
ND
05
—
13112
—
ND
01
—
137094
UCARE #
ND
01
—
2155911
AMERICA'S PPO/ARAZ #
ND
01
—
24613
NDBS #
ND
01
—
34894
LHS #
ND
01
—
850S5GE
MNBS #
ND
05
—
856410800
—
ND
01
—
DA9011041661
PREFERRED ONE #
ND
01
—
HP44194
HEALTHPARTNERS #
ND
Enumeration date
07/10/2006
Last updated
10/10/2011
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