Individual
DR. KRISTI J MIDGARDEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
503 PARK ST W, PARK RIVER, ND 58270-4103
(701) 284-6663
(701) 284-6923
Mailing address
503 PARK ST W, PARK RIVER, ND 58270-4103
(701) 284-6663
(701) 284-6923
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
8012
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
10874
—
ND
01
—
28252
BCBS OF ND
ND
01
—
924G8MI
BLUE CROSS BLUE SHIELD
MN
01
—
926220200
MEDICAID
MN
Enumeration date
10/24/2006
Last updated
12/31/2013
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