Kvistad, Bonnie S

Kvistad, Bonnie S is an individual health care provider with primary practice located at 2701 13Th Ave S , Fargo ND 58103-3602. She recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as her primary health care specialty. Kvistad, Bonnie S can be contacted via phone (701) 234-3620.

Contact Information

Primary practice address
2701 13Th Ave S Fargo ND 58103-3602
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X PT11205 North Dakota
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 49784 Minnesota
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 11205 North Dakota

Profile Details

NPI number 1659491090
LBN Legal business name Kvistad, Bonnie S
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 30th, 2007
Last updated Mar 25th, 2022 - about 2 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 1659491090 NPPES
Minnesota MEDICAID 724690000

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