Individual
AMBEREEN ALAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1200 S COLUMBIA RD, GRAND FORKS, ND 58201
(701) 780-5000
(618) 876-0807
Mailing address
2401 DEMERS AVE, GRAND FORKS, ND 58201
(701) 780-1891
(618) 876-0807
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
036114367
IL
208000000X
Pediatrics Physician
Primary
18869
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036114367
—
IL
Enumeration date
08/27/2007
Last updated
12/15/2022
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