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Contact Information

DOREEN J GIGSTAD STAVE, PA-C
801 BROADWAY N
FARGO, ND58102-3641
 Phone: 701-234-2261
 Fax: 701-234-2080
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Medical

363AM0700X 97 Physician Assistant
Indicates primary specialty

NPI Profile & details for DOREEN J GIGSTAD STAVE · (Female)

NPI Number 1497772354
Status Active
Credentials PA-C (Physician Assistant-Certified)
Entity Individual
Enumeration date 07/16/2006
Last updated 10/16/2012 - About 14 years ago
Sole proprietor 1 No
Identifiers
  • ND License # PAC0028
  • MN Medicaid 307195200
  • ND Medicaid 71097
Hospital affiliation(s)
  • SANFORD MEDICAL CENTER FARGO - (Acute Care)
    801 BROADWAY NORTH
    FARGO, ND 58122
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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