Provider Demographics
NPI:1902978455
Name:HONL, BETH A (MD)
Entity type:Individual
Prefix:DR
First Name:BETH
Middle Name:A
Last Name:HONL
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2101 ELM ST N
Mailing Address - Street 2:
Mailing Address - City:FARGO
Mailing Address - State:ND
Mailing Address - Zip Code:58102-2417
Mailing Address - Country:US
Mailing Address - Phone:701-237-3700
Mailing Address - Fax:701-237-2683
Practice Address - Street 1:2101 ELM ST N
Practice Address - Street 2:
Practice Address - City:FARGO
Practice Address - State:ND
Practice Address - Zip Code:58102-2417
Practice Address - Country:US
Practice Address - Phone:701-237-3700
Practice Address - Fax:701-237-2683
Is Sole Proprietor?:No
Enumeration Date:2006-11-13
Last Update Date:2025-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND7119207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN246K8HOOtherBLUE SHIELD OF MN
ND024009OtherBLUE SHIELD OF ND
MN026092400Medicaid
ND11917Medicaid
MN026092400Medicaid
ND024009OtherBLUE SHIELD OF ND