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Individual

ROGER L GILBERTSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
737 BROADWAY, FARGO, ND 58122-0001
(701) 234-6960
(701) 234-6979
Mailing address
737 BROADWAY, FARGO, ND 58122-0001
(701) 234-6960
(701) 234-6979

Taxonomy

Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
16575
MN
2085R0202X
Diagnostic Radiology Physician
Primary
3152
ND

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
12364
ND
01
1624696
MEDICA
01
4617
NDBC
01
895001
PREFERRED ONE
01
90926GI
MNBC
01
HP10479
HEALTHPARTNERS
Enumeration date
06/28/2006
Last updated
07/08/2007
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