| Organization Name: | HANS BJELLUM MD PC |
| NPI Number: | 1972769826 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | HANS BJELLUM (OWNER) |
| Mailing Address: | 1517 32nd Ave S Fargo |
| State: | ND US |
| Postal Code: | 581035905 |
| Phone Number: | 7012326211 |
| Fax Number: | 7013649346 |
| NPI Enumeration Date: | 07/30/2008 |
| NPI Last Update Date: | 07/30/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | 41143 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MN |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |