Individual
PRAVEEN JINNUR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1702 UNIVERSITY DR S, FARGO, ND 58103-4940
(701) 364-3300
(701) 364-8906
Mailing address
1702 UNIVERSITY DR S, FARGO, ND 58103-4940
(701) 364-3300
(701) 364-8906
Taxonomy
Speciality
Code
Description
License number
State
207RP1001X
Pulmonary Disease Physician
Primary
13606
ND
207RS0012X
Sleep Medicine (Internal Medicine) Physician
13606
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
ENROLLED
—
IA
05
—
ENROLLED
—
MN
Enumeration date
12/19/2010
Last updated
03/09/2023
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