Individual
GARY M KUBALAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
801 BROADWAY N, FARGO, ND 58102-3641
(701) 234-2000
(701) 234-2050
Mailing address
PO BOX 5074, SIOUX FALLS, SD 57117-5074
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
6591
ND
2086S0127X
Trauma Surgery Physician
Primary
6591
ND
2086S0129X
Vascular Surgery Physician
6591
ND
Other
Enumeration date
07/17/2006
Last updated
02/03/2025
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