Provider Demographics
NPI:1326071259
Name:BURESH, JARROD ALAN (DO)
Entity Type:Individual
Prefix:DR
First Name:JARROD
Middle Name:ALAN
Last Name:BURESH
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1000 E 1ST ST
Mailing Address - Street 2:STE. 203
Mailing Address - City:DULUTH
Mailing Address - State:MN
Mailing Address - Zip Code:55805-2297
Mailing Address - Country:US
Mailing Address - Phone:218-249-6450
Mailing Address - Fax:218-249-6451
Practice Address - Street 1:1000 E 1ST ST
Practice Address - Street 2:STE. 203
Practice Address - City:DULUTH
Practice Address - State:MN
Practice Address - Zip Code:55805-2297
Practice Address - Country:US
Practice Address - Phone:218-249-6450
Practice Address - Fax:218-249-6451
Is Sole Proprietor?:No
Enumeration Date:2006-07-07
Last Update Date:2020-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN53863208600000X, 2086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery
No208600000XAllopathic & Osteopathic PhysiciansSurgery