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2601 University Dr S, Fargo, ND 58103-6025 | |
(701) 235-5200 | |
(701) 237-0927 |
Full Name | |
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Type | Facility |
Speciality | Specialist |
Location | 2601 University Dr S, Fargo, North Dakota |
Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1801819826 | NPI | - | NPPES |
01068001 | Other | ND | BLUE CROSS OF ND |
33A70BE | Other | MN | COMPREHENSIVE CARE SERVIC |
33A70BE | Other | MN | BLUEPLUS OF MN |
12698 | Medicaid | ND | |
33A70BE | Other | MN | BLUE CROSS OF MN |
01068001 | Other | ND | BLUE CROSS FEDERAL |
Provider Name | Lance K Bergstrom |
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Provider Type | Practitioner - Ophthalmology |
Provider Identifiers | NPI Number: 1578509733 PECOS PAC ID: 5092794735 Enrollment ID: I20100825000247 |
Provider Name | Tracie Malsom |
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Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1720038441 PECOS PAC ID: 8628085750 Enrollment ID: I20131126001931 |
Provider Name | Matthew Stein |
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Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1205501095 PECOS PAC ID: 6507261708 Enrollment ID: I20210826001498 |
Provider Name | Cody Scott Ward |
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Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1184364093 PECOS PAC ID: 6305282914 Enrollment ID: I20240416002398 |
Mailing Address | Practice Location Address |
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2601 University Dr S, Fargo, ND 58103-6025 Ph: (701) 235-5200 | 2601 University Dr S, Fargo, ND 58103-6025 Ph: (701) 235-5200 |