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Individual

GWEN ELIZABETH THOMPSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
3000 32ND AVE S, FARGO, ND 58103
(701) 364-8000
(701) 364-8078
Mailing address
400 E 3RD ST, DULUTH, MN 55805-1951

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
58242
MN
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
Primary
PT15713
ND
207RP1001X
Pulmonary Disease Physician
58242
MN
207RP1001X
Pulmonary Disease Physician
PT15713
ND

Other

Enumeration date
06/14/2013
Last updated
06/28/2019
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