Provider Demographics
NPI:1710052626
Name:SELLAND, BRIAN L (MD)
Entity Type:Individual
Prefix:
First Name:BRIAN
Middle Name:L
Last Name:SELLAND
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 1:115 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:DUNSEITH
Mailing Address - State:ND
Mailing Address - Zip Code:58329-0100
Mailing Address - Country:US
Mailing Address - Phone:701-681-9888
Mailing Address - Fax:701-244-5801
Practice Address - Street 1:800 3RD AVE SW
Practice Address - Street 2:
Practice Address - City:RUGBY
Practice Address - State:ND
Practice Address - Zip Code:58368-1645
Practice Address - Country:US
Practice Address - Phone:701-776-5235
Practice Address - Fax:701-776-5297
Is Sole Proprietor?:No
Enumeration Date:2006-11-24
Last Update Date:2020-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND6819207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
ND17848Medicaid
ND17848Medicaid
NDN712900Medicare PIN