Forward, Brennan Micheal

Forward, Brennan Micheal is an sole proprietor health care provider with primary practice located at 801 Broadway N , Fargo ND 58102-3641. He recently has 2 registered licenses in different health care specialties including Student, Health Care / Student in an Organized Health Care Education/Training Program, Allopathic & Osteopathic Physicians / Pediatrics. Allopathic & Osteopathic Physicians / Pediatrics is his primary health care specialty. Forward, Brennan Micheal can be contacted via phone (701) 234-3200.

Contact Information

Primary practice address
801 Broadway N Fargo ND 58102-3641
Phone: (701) 234-3200
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Student, Health Care / Student in an Organized Health Care Education/Training Program 390200000X
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 58335 Minnesota
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 13334 North Dakota

Profile Details

NPI number 1659663557
LBN Legal business name Forward, Brennan Micheal
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date May 10th, 2011
Last updated Apr 27th, 2015 - about 10 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1659663557 NPPES
North Dakota MEDICAID 81192

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