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Individual

DR. KENNETH M. GHEEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
801 BROADWAY N, FARGO, ND 58102-3641
(701) 234-7428
Mailing address
801 BROADWAY N, FARGO, ND 58102-3641

Taxonomy

Speciality
Code
Description
License number
State
2080P0203X
Pediatric Critical Care Medicine Physician
Primary
11287
ND
2080P0203X
Pediatric Critical Care Medicine Physician
26846
CO

Other

Enumeration date
05/17/2006
Last updated
01/19/2012
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