Organization
MERITCARE MEDICAL GROUP
Active
Other names
MeritCare Dermatology & Laser Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
LISA M CARLSON (CFO)
(701) 234-4811
Entity
Organization
Contact information
Practice address
4656 40TH AVE S, FARGO, ND 58104-4394
(701) 234-8860
(701) 234-8924
Mailing address
4656 40TH AVE S, FARGO, ND 58104-4394
(701) 234-8860
(701) 234-8924
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
—
—
Other
Enumeration date
06/27/2008
Last updated
11/27/2023
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