Provider Demographics
NPI:1285868901
Name:FOLKESTAD, DYLAN G (MD)
Entity type:Individual
Prefix:DR
First Name:DYLAN
Middle Name:G
Last Name:FOLKESTAD
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:415 JEFFERSON ST NORTH
Mailing Address - Street 2:TRI-COUNTY HEALTH CARE
Mailing Address - City:WADENA
Mailing Address - State:MN
Mailing Address - Zip Code:56482-1296
Mailing Address - Country:US
Mailing Address - Phone:218-631-3510
Mailing Address - Fax:218-631-7503
Practice Address - Street 1:401 DOUGLAS AVE
Practice Address - Street 2:TRI-COUNTY HEALTH CARE HENNING CLINIC
Practice Address - City:HENNING
Practice Address - State:MN
Practice Address - Zip Code:56551
Practice Address - Country:US
Practice Address - Phone:218-583-2953
Practice Address - Fax:218-583-4521
Is Sole Proprietor?:No
Enumeration Date:2009-05-09
Last Update Date:2024-02-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
390200000X
MN52995207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program