Individual
JOHN J HAGAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
900 E BROADWAY AVENUE, BISMARCK, ND 58501
(701) 530-7000
(701) 530-8842
Mailing address
900 E BROADWAY AVENUE, P.O. BOX 997, BISMARCK, ND 58502-0997
(701) 530-7000
(701) 530-8842
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
8370
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
11248
—
ND
01
—
P00137588
RR MEDICARE
ND
Enumeration date
01/23/2007
Last updated
01/28/2008
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