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Individual

ANU G GABA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
820 4TH ST N, FARGO, ND 58122-0001
(701) 234-6161
(701) 234-7257
Mailing address
820 4TH ST N, FARGO, ND 58122-0001
(701) 234-6161
(701) 234-7257

Taxonomy

Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
47654
MN
207RH0003X
Hematology & Oncology Physician
Primary
9598
ND

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1041215
PREFERREDONE
05
13055
ND
01
24359
NDBCBS
01
3600498
MEDICA
05
567465400
MN
05
7714340
SD
01
820S4GA
MN BCBS
01
HP42398
HEALTHPARTNERS
Enumeration date
07/16/2006
Last updated
02/14/2021
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