Individual
DR. JON DAVID NORBERG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
9325 UPLAND LN N STE 255, MAPLE GROVE, MN 55369-4463
(763) 465-4263
(763) 314-2026
Mailing address
9325 UPLAND LN N STE 255, MAPLE GROVE, MN 55369-4463
(763) 465-4263
(763) 314-2026
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
63419
MN
207X00000X
Orthopaedic Surgery Physician
9161
ND
207XS0106X
Orthopaedic Hand Surgery Physician
63419
MN
2086S0105X
Surgery of the Hand (Surgery) Physician
63419
MN
2086S0105X
Surgery of the Hand (Surgery) Physician
9161
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
12017
—
ND
05
—
278676100
—
MN
01
—
307M9NO
MN BLUE SHIELD
MN
01
—
63419
PROFESSIONAL LICENSE
MN
01
—
NOR24461
ND BLUE SHIELD
ND
01
—
P00139507
PALMETTO GBA-RR MEDICARE
ND
Enumeration date
06/09/2005
Last updated
10/30/2024
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