Individual
MARK C BLAUFUSS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
801 BROADWAY N, FARGO, ND 58102-3641
(701) 234-2431
(701) 234-3740
Mailing address
PO BOX 2010, FARGO, ND 58122-0605
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
5060
ND
2080P0206X
Pediatric Gastroenterology Physician
Primary
5060
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
14687
—
ND
Enumeration date
07/18/2006
Last updated
01/05/2012
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