Provider Demographics
NPI:1578501672
Name:VELANDER, BYRON ALAN (MD)
Entity Type:Individual
Prefix:DR
First Name:BYRON
Middle Name:ALAN
Last Name:VELANDER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1451 44TH AVENUE SOUTH
Mailing Address - Street 2:SUITE #112D
Mailing Address - City:GRAND FORKS
Mailing Address - State:ND
Mailing Address - Zip Code:58201
Mailing Address - Country:US
Mailing Address - Phone:701-775-5800
Mailing Address - Fax:701-775-5200
Practice Address - Street 1:1451 44TH AVENUE SOUTH
Practice Address - Street 2:SUITE #112-D
Practice Address - City:GRAND FORKS
Practice Address - State:ND
Practice Address - Zip Code:58201
Practice Address - Country:US
Practice Address - Phone:701-775-5800
Practice Address - Fax:701-775-5200
Is Sole Proprietor?:No
Enumeration Date:2006-06-02
Last Update Date:2022-11-23
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IL036-111489207RA0000X
MT112716207RA0000X
ND11312207RA0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RA0000XAllopathic & Osteopathic PhysiciansInternal MedicineAdolescent Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036-111489Medicaid
ND11251Medicaid
ILI17146Medicare UPIN
ND11251Medicaid