Brandon Haugrud

Individual provider Active NPI Student in an Organized Health Care Education/Training Program · Grand Forks, ND

NPI 1750130480 · NPPES record last updated May 15, 2024

Key facts

NPI
1750130480
Entity type
Individual (NPI type 1)
Primary specialty
Student in an Organized Health Care Education/Training Program 390200000X
Practice address
725 Hamline St
Grand Forks, ND 58203-2819
Phone
(701) 780-6810
NPI assigned
May 15, 2024
Sex
Male
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Enrolled in ND
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20240711000970 ND Order and Referring Only - Family Practice
Practitioner - Family Practice
4789129016

National Provider Directory

Medicare enrollment (NPD)
Yes

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X Yes

Addresses

Primary practice location

725 Hamline St
Grand Forks, ND 58203-2819

Mailing address

725 Hamline St
Grand Forks, ND 58203-2819

Other providers in Grand Forks, ND

All providers in Grand Forks, ND · Student in an Organized Health Care Education/Training Program in North Dakota

Sources for this page

Verify at the official NPI Registry.