Provider Demographics
NPI:1982031746
Name:TURTLE MOUNTAIN FAMILY MEDICINE, LLC
Entity Type:Organization
Organization Name:TURTLE MOUNTAIN FAMILY MEDICINE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:SELLAND
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:701-244-5800
Mailing Address - Street 1:115 MAIN STREET NE
Mailing Address - Street 2:
Mailing Address - City:DUNSEITH
Mailing Address - State:ND
Mailing Address - Zip Code:58329
Mailing Address - Country:US
Mailing Address - Phone:701-244-5800
Mailing Address - Fax:701-244-5801
Practice Address - Street 1:115 MAIN STREET NE
Practice Address - Street 2:
Practice Address - City:DUNSEITH
Practice Address - State:ND
Practice Address - Zip Code:58329
Practice Address - Country:US
Practice Address - Phone:701-244-5800
Practice Address - Fax:701-244-5801
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-10-10
Last Update Date:2014-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty