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Individual

DONALD R. GULLICKS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
4000 28TH AVE S, MOORHEAD, MN 56560-7926
(701) 234-3200
(701) 234-3239
Mailing address
PO BOX 2168, FARGO, ND 58107-2168
(701) 234-2119

Taxonomy

Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
13170
ND
207V00000X
Obstetrics & Gynecology Physician
2010020741
MO
207V00000X
Obstetrics & Gynecology Physician
Primary
TP107788
MN

Other

Enumeration date
06/24/2010
Last updated
10/22/2014
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