DANIEL G MICKELSON


Address: 737 Broadway, Fargo, ND 58122-0001
Phone: 7012342000

DANIEL G MICKELSON (NPI# 1215954854) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1215954854
Entity Type Individual
Full Name DANIEL G MICKELSON
Credential MD
Practice Address 737 Broadway
Fargo
ND 58122-0001
Mailing Address 801 Broadway N
Fargo
ND 58102-3641
Practice Telephone 7012342000
Practice Fax Number 7012347332
Mailing Telephone 7012342000
Mailing Fax Number 7012347332
Enumeration Date 2006-07-17
Last Update Date 2011-11-30
Gender Code M
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
N 2085R0202X Radiology
Specialization: Diagnostic Radiology
5819 ND Allopathic & Osteopathic Physicians
Y 2085R0204X Radiology
Specialization: Vascular & Interventional Radiology
5819 ND Allopathic & Osteopathic Physicians

Office Location

Street Address 737 BROADWAY
City FARGO
State ND
Zip Code 58122-0001

Providers in the same location

NPI Name Taxonomy Address Enumeration
1437103959 Robin J Sickels Dietitian, Registered 737 Broadway, Fargo, ND 58122-0001 2006-05-20
1679883680 Summer Schauer Nurse Anesthetist, Certified Registered 737 Broadway, Fargo, ND 58122-0001 2010-10-13
1588974596 Melissa Vanmatre Nurse Anesthetist, Certified Registered 737 Broadway, Fargo, ND 58122-0001 2010-10-13
1164652640 Sanford Clinic North Clinical Medical Laboratory 737 Broadway, Fargo, ND 58122-0045 2009-07-20
1710138375 Kent C Moser Nurse Anesthetist, Certified Registered 737 Broadway, Fargo, ND 58122-0001 2008-10-01
1023268711 Katie C Busker Nurse Anesthetist, Certified Registered 737 Broadway, Fargo, ND 58122 2008-09-30
1770731473 Andrea B Peterson Nurse Practitioner 737 Broadway, Fargo, ND 58122-0001 2008-09-05
1801091384 Vijay Korimilli Internal Medicine 737 Broadway, Fargo, ND 58122-0001 2007-06-15
1437362571 Heidi J Lako-adamson Emergency Medicine 737 Broadway, Fargo, ND 58122-0001 2007-05-07
1164567970 Kristen M Liebl Dietary Manager 737 Broadway, Fargo, ND 58122-0001 2007-02-20
Find all providers in the same location

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1184142747 Kayla Estepp Internal Medicine 737 Broadway North, Fargo, ND 58122 2017-09-05
1376091793 Paul Mckay Physical Therapist 801 Broadway N., Fargo, ND 58122 2016-09-14
1801290150 Mark Noah Physical Therapist 1720 South University, Fargo, ND 58122 2014-10-15
1245633486 Diana Palm Physical Therapist 1720 University Drive South, Fargo, ND 58122 2014-10-02
1447696406 Mohamad Imam Internal Medicine 801 Broadway North, Fargo, ND 58122 2013-05-17
1457615155 Chantee Seung Gruenhagen Nurse Practitioner 737 North Broadway, Sanford Urology Clinic, Fargo, ND 58122 2012-06-27
1457594079 Manisha Balhara Specialist 2400 32nd Avenue S, Fargo, ND 58122 2009-04-13
1578536728 Shelby A Terstriep Internal Medicine 820 4 Street North, Fargo, NC 58122 2006-02-08
1295229946 Christopher Hinh Student in an Organized Health Care Education/Training Program 801 Broadway North, Fargo, ND 58122 2018-06-17
1558854539 Suchita Kotnala Family Medicine 737 Broadway North, Fargo, ND 58122 2018-06-13
Find all providers in zip 58122

Taxonomy Information

Taxonomy Code 2085R0204X
Grouping Allopathic & Osteopathic Physicians
Classification Radiology
Specialization Vascular & Interventional Radiology

Taxonomy Definition

A radiologist who diagnoses and treats diseases by various radiologic imaging modalities. These include fluoroscopy, digital radiography, computed tomography, sonography and magnetic resonance imaging.
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added] Additional Resources: American Board of Radiology, 2007. http://www.theabr.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Radiology.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1003044975 Adam John Defoe Radiology 3000 32nd Ave S, Fargo, ND 58103-6132 2009-06-30
1992949325 Richard Monroe Penney Radiology 5225 23rd Ave S, Fargo, ND 58104-7927 2009-04-29
1669490264 Eric R Promersberger Radiology 801 Broadway N, Fargo, ND 58102-3641 2006-07-18

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1336481415 Barry Joseph Amos Radiology 1 Burdick Expy W, Minot, ND 58701-4406 2013-03-26
1629236690 Sridhar Naidu Radiology #1 Burdick Expy W, Minot, ND 58701-4406 2008-05-27
1154417418 Randall J Smith Radiology 1200 S Columbia Rd, Grand Forks, ND 58201-4036 2006-10-05
1063508323 Gerald S Smyser Radiology 1200 S Columbia Rd, Grand Forks, ND 58201-4036 2006-10-05

Competitor

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City FARGO
Zip Code 58122

Improve Information

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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