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Contact Information

BRIAN J GRONDAHL, DO
3000 32ND AVE S
FARGO, ND58103-6132
 Phone: 701-364-8000
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Cardiovascular Disease

207RC0000X 11 Physician/Internal Medicine
 

Internal Medicine

207R00000X 11 Physician/Internal Medicine
Indicates primary specialty

NPI Profile & details for BRIAN J GRONDAHL · (Male)

NPI # 1750710554
Status Active
Credentials DO (Doctor of Osteopathic)
Entity Individual
Enumeration date 11/02/2013
Last updated 06/07/2021 - About 5 years ago
Sole proprietor 1 No
Identifiers
  • MI License # 5101021290
  • MN License # 68988
  • ND License # 17241
Hospital affiliation(s)
  • ESSENTIA HEALTH ST MARYS - (Acute Care)
    1027 WASHINGTON AVE
    DETROIT LAKES, MN 56501
  • ESSENTIA HEALTH-FARGO - (Acute Care)
    3000 32ND AVE SOUTH
    FARGO, ND 58104
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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