Provider Demographics
NPI:1063747012
Name:J DONALD OPGRANDE PC
Entity type:Organization
Organization Name:J DONALD OPGRANDE PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:J
Authorized Official - Middle Name:DONALD
Authorized Official - Last Name:OPGRANDE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:701-232-2848
Mailing Address - Street 1:2301 25TH ST S
Mailing Address - Street 2:SUITE G
Mailing Address - City:FARGO
Mailing Address - State:ND
Mailing Address - Zip Code:58103-6104
Mailing Address - Country:US
Mailing Address - Phone:701-232-2848
Mailing Address - Fax:701-232-0054
Practice Address - Street 1:2301 25TH ST S
Practice Address - Street 2:SUITE G
Practice Address - City:FARGO
Practice Address - State:ND
Practice Address - Zip Code:58103-6104
Practice Address - Country:US
Practice Address - Phone:701-232-2848
Practice Address - Fax:701-232-0054
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-10-08
Last Update Date:2009-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207XS0106XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryHand SurgeryGroup - Single Specialty