Provider Demographics
NPI:1366470601
Name:BJORK, DAVID T (MD)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:T
Last Name:BJORK
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:712 SOUTH CASCADE STREET
Mailing Address - Street 2:
Mailing Address - City:FERGUS FALLS
Mailing Address - State:MN
Mailing Address - Zip Code:56537-2813
Mailing Address - Country:US
Mailing Address - Phone:218-736-8000
Mailing Address - Fax:218-739-6742
Practice Address - Street 1:712 SOUTH CASCADE STREET
Practice Address - Street 2:
Practice Address - City:FERGUS FALLS
Practice Address - State:MN
Practice Address - Zip Code:56537-2813
Practice Address - Country:US
Practice Address - Phone:218-736-8000
Practice Address - Fax:218-739-6742
Is Sole Proprietor?:No
Enumeration Date:2006-06-28
Last Update Date:2017-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN25165207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN123439OtherDTB UCARE #
MN61080BJOtherDTB BCBS #
MN795005500Medicaid
MN04-00525OtherDTB MEDICA #
MN060010197OtherDTB MEDICARE RR #
MN1008785OtherDTB PREFERRED ONE #
ND12183Medicaid
MNHP26580OtherDTB HEALTHPARTNERS #
MN41-0917444OtherDTB ONE HEALTH PLAN
TX1476533Medicaid
MNHP26580OtherDTB HEALTHPARTNERS #
MN119001714Medicare ID - Type UnspecifiedDTB MEDICARE #
ND12183Medicaid