Provider Demographics
NPI:1790931467
Name:HANS BJELLUM, MD, PC
Entity Type:Organization
Organization Name:HANS BJELLUM, MD, PC
Other - Org Name:7 DAY CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:HANS
Authorized Official - Middle Name:
Authorized Official - Last Name:BJELLUM
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:701-232-6211
Mailing Address - Street 1:4622 40TH AVE S
Mailing Address - Street 2:
Mailing Address - City:FARGO
Mailing Address - State:ND
Mailing Address - Zip Code:58104-4394
Mailing Address - Country:US
Mailing Address - Phone:701-232-6211
Mailing Address - Fax:
Practice Address - Street 1:720 MAIN AVE
Practice Address - Street 2:
Practice Address - City:MOORHEAD
Practice Address - State:MN
Practice Address - Zip Code:56560-2752
Practice Address - Country:US
Practice Address - Phone:701-232-6211
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-08-14
Last Update Date:2008-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care