Lillestol, Michael John

Lillestol, Michael John is an individual health care provider with primary practice located at 1707 Gold Dr Ste 101, Fargo ND 58103-6413. He recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as his primary health care specialty. Lillestol, Michael John can be contacted via phone (701) 280-2033.

Contact Information

Primary practice address
1707 Gold Dr Ste 101 Fargo ND 58103-6413
Phone: (701) 280-2033
Fax: (701) 232-5578
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X 4830 North Dakota

Profile Details

NPI number 1669427688
LBN Legal business name Lillestol, Michael John
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 25th, 2006
Last updated Aug 27th, 2010 - about 14 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 1669427688 NPPES
North Dakota Other D26082 ND WORKERS COMP
North Dakota MEDICAID 14165 ND WORKERS COMP
North Dakota Other 162D9LI ND WORKERS COMP
North Dakota Other 21574 ND WORKERS COMP
North Dakota Other 1008297 ND WORKERS COMP
North Dakota Other 116742 ND WORKERS COMP
North Dakota Other 04-12025 ND WORKERS COMP
North Dakota MEDICAID 663288200 ND WORKERS COMP
North Dakota Other ND4830 ND WORKERS COMP
North Dakota Other 141875400 ND WORKERS COMP

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