Individual
NATHAN B HAGEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
115 SOUTH ST, MICHIGAN COMMUNITY MEDICAL CLINIC, MICHIGAN, ND 58259-0290
(701) 259-2119
(701) 259-2319
Mailing address
PO BOX 290, 115 SO ST, MICHIGAN, ND 58259-0290
(701) 259-2119
(701) 259-2319
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
3113
ND
208D00000X
General Practice Physician
3113
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
11257
—
ND
01
—
33401
REFERRING
—
Enumeration date
10/19/2006
Last updated
10/29/2007
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