Provider Demographics
NPI:1821127036
Name:GAID, EVANGELINE S (MD)
Entity Type:Individual
Prefix:DR
First Name:EVANGELINE
Middle Name:S
Last Name:GAID
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:1703 BURKE BLVD
Mailing Address - Street 2:
Mailing Address - City:DEVILS LAKE
Mailing Address - State:ND
Mailing Address - Zip Code:58301-9072
Mailing Address - Country:US
Mailing Address - Phone:701-766-1600
Mailing Address - Fax:701-766-1626
Practice Address - Street 1:3883 74TH AVE.NE
Practice Address - Street 2:
Practice Address - City:FT. TOTTEN
Practice Address - State:ND
Practice Address - Zip Code:58335
Practice Address - Country:US
Practice Address - Phone:701-766-1600
Practice Address - Fax:701-766-1726
Is Sole Proprietor?:No
Enumeration Date:2007-03-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
ND6062207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
ND01061Medicaid
ND8HE775Medicare ID - Type Unspecified
ND01061Medicaid