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Individual

DAVID J GLATT

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
2400 32ND AVE S, FARGO, ND 58103-5800
(701) 234-8330
(701) 234-3672
Mailing address
2400 32ND AVE S, FARGO, ND 58103-5800
(701) 234-8330
(701) 234-3672

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
28271
MN
207Q00000X
Family Medicine Physician
Primary
3775
ND

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0121003
MEDICA
05
12348
ND
05
167588500
MN
01
1897
NDBC
01
896133
PREFRRED ONE
01
90792GL
MNBC
01
HP10483
HEALTHPARNTERS
Enumeration date
06/27/2006
Last updated
04/06/2022
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