Provider Demographics
NPI:1972682532
Name:ESPEJO, NAPOLEON R (MD)
Entity Type:Individual
Prefix:DR
First Name:NAPOLEON
Middle Name:R
Last Name:ESPEJO
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:PO BOX 2625
Mailing Address - Street 2:
Mailing Address - City:FARGO
Mailing Address - State:ND
Mailing Address - Zip Code:58108-2625
Mailing Address - Country:US
Mailing Address - Phone:701-271-3344
Mailing Address - Fax:701-271-3347
Practice Address - Street 1:301 NP AVE N
Practice Address - Street 2:
Practice Address - City:FARGO
Practice Address - State:ND
Practice Address - Zip Code:58102-4835
Practice Address - Country:US
Practice Address - Phone:701-271-3344
Practice Address - Fax:701-271-3343
Is Sole Proprietor?:No
Enumeration Date:2006-11-03
Last Update Date:2016-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND8008207Q00000X
MN40268207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN262773600Medicaid
ND11007Medicaid
ND15773Medicare ID - Type Unspecified
ND11007Medicaid