Individual
DR. JEREMY FORREST BRUDEVOLD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
801 BROADWAY N, FARGO, ND 58102-3641
(701) 234-5121
Mailing address
PO BOX 5074, SIOUX FALLS, SD 57117-5074
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
12740
ND
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
05/27/2010
Last updated
09/04/2024
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