Individual
DONALD J STALLMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
801 BROADWAY N, FARGO, ND 58102-3641
(701) 234-2406
(701) 234-6072
Mailing address
PO BOX 5074, SIOUX FALLS, SD 57117-5074
(701) 234-2000
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
7467
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
18765
—
ND
05
—
359719900
—
MN
05
—
81402
—
ND
05
—
81403
—
ND
05
—
81404
—
ND
05
—
81405
—
ND
05
—
81406
—
ND
05
—
81407
—
ND
Enumeration date
07/22/2006
Last updated
04/18/2024
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