Provider Demographics
NPI:1821292087
Name:BJOERNSEN, LARS (MD)
Entity Type:Individual
Prefix:DR
First Name:LARS
Middle Name:
Last Name:BJOERNSEN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:LARS PETTER
Other - Middle Name:BACHE-WIIG
Other - Last Name:BJORNSEN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:2051 ALLEN BLVD
Mailing Address - Street 2:APT 201
Mailing Address - City:MIDDLETON
Mailing Address - State:WI
Mailing Address - Zip Code:53562-3456
Mailing Address - Country:US
Mailing Address - Phone:608-556-8214
Mailing Address - Fax:
Practice Address - Street 1:STABELLSVEI 7A
Practice Address - Street 2:
Practice Address - City:TRONDHEIM
Practice Address - State:SOR-TRONDELAG
Practice Address - Zip Code:7021
Practice Address - Country:NO
Practice Address - Phone:011479-321-2617
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-12
Last Update Date:2014-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI52690-20207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine