Individual
DR. GAYLORD J KAVLIE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
401 N 9TH ST, BISMARCK, ND 58501-4507
(701) 530-6000
(701) 530-6430
Mailing address
401 N 9TH ST, BISMARCK, ND 58501-4507
(701) 530-6000
(701) 530-6430
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
4593
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
020018423
MEDICARE RAILROAD
ND
05
—
14680
—
ND
Enumeration date
05/24/2006
Last updated
12/09/2014
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