Provider Demographics
NPI:1821189622
Name:LANGLOIS, TRICIA J (MD)
Entity Type:Individual
Prefix:
First Name:TRICIA
Middle Name:J
Last Name:LANGLOIS
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:1701 38TH ST S
Mailing Address - Street 2:SUITE 101
Mailing Address - City:FARGO
Mailing Address - State:ND
Mailing Address - Zip Code:58103-4499
Mailing Address - Country:US
Mailing Address - Phone:701-356-1600
Mailing Address - Fax:701-356-1589
Practice Address - Street 1:1701 38TH ST S
Practice Address - Street 2:SUITE 101
Practice Address - City:FARGO
Practice Address - State:ND
Practice Address - Zip Code:58103-4499
Practice Address - Country:US
Practice Address - Phone:701-356-1600
Practice Address - Fax:701-356-1589
Is Sole Proprietor?:No
Enumeration Date:2006-09-27
Last Update Date:2014-10-20
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
ND9794207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NDG25829Medicare UPIN