Individual
ASELO V LAYAWEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
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) 364-3300
(701) 364-8906
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
9464
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0408684
MEDICA
—
01
—
1034901
PREFERREDONE
—
05
—
12492
—
ND
01
—
2433967
AMERICAS PPO
—
01
—
26744
BCBS ND
—
01
—
96G36LA
MN BCBS
—
01
—
HP42582
HEALTHPARTNERS
—
Enumeration date
07/29/2006
Last updated
05/01/2009
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