Individual
GREGORY P STOMPRO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
2301 25TH ST S, FARGO, ND 58103-6104
(701) 237-9712
(701) 237-0922
Mailing address
2301 25TH ST S, FARGO, ND 58103-6104
(701) 237-9712
(701) 237-0922
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PAC0078
ND
363AM0700X
Medical Physician Assistant
PAC0078
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
382147100
—
MN
05
—
71055
—
ND
Enumeration date
07/22/2006
Last updated
01/20/2017
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