DR. DONALD MELVIN LARSON (NPI# 1417167628) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1417167628 |
| Entity Type | Individual |
| Full Name | DR. DONALD MELVIN LARSON |
| Credential | M.D. |
| Practice Address |
2866 Lilac Ln N Fargo ND 58102-1703 |
| Practice Telephone | 7012935167 |
| Mailing Telephone | 7012935167 |
| Enumeration Date | 2007-05-23 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2084N0400X |
Psychiatry & Neurology Specialization: Neurology |
2987 | ND | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073890299 | Donald Edward Larson Jr. | Pharmacist | 62 Midway Dr, Orchard Park, NY 14127-3040 | 2011-11-16 |
| 1235435744 | Donald E Larson | Dentist | 700 E State St Ste 100, Eagle, ID 83616-5941 | 2011-01-31 |
| 1083617435 | Donald F Larson | Dentist | 814 N Saint Asaph St, Fl 2, Alexandria, VA 22314-1718 | 2005-05-31 |
| Street Address |
2866 LILAC LN N |
| City | FARGO |
| State | ND |
| Zip Code | 58102-1703 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780285924 | Shelley Dene Townsend-hansen | Dentist | 1017 Broadway N, Fargo, ND 58102 | 2020-11-04 |
| 1275190779 | Anthony Joseph Duncan | Student in an Organized Health Care Education/Training Program | 1919 Elm Streent North, Fargo, ND 58102 | 2019-05-21 |
| 1003472317 | Sadie Marie Nelson | Nurse Practitioner | Sanford Broadway Clinic, 801 North Broadway, Fargo, ND 58102 | 2019-05-13 |
| 1124523576 | Christopher Peroutka | Specialist/Technologist | 1300 17th Ave N, Fargo, ND 58102 | 2018-03-28 |
| 1205331873 | Nathan Koens | Specialist/Technologist | 1300 17th Avenue North, Fargo, ND 58102 | 2018-03-27 |
| 1376063370 | Abby Nicole Fredrickson | Student in an Organized Health Care Education/Training Program | 1919 Elm Street North, Fargo, ND 58102 | 2017-06-21 |
| 1780118331 | Stephanie Melquist | Internal Medicine | Internal Medicine Resident Clinic, 801 N Broadway, Fargo, ND 58102 | 2017-04-19 |
| 1104215623 | Justin Lervik | Social Worker | 211 Elm St. N, 122, Fargo, ND 58102 | 2015-01-21 |
| 1770919441 | Courtney Ann Simanski | Speech-Language Pathologist | 415 4th St. N., Fargo, ND 58102 | 2013-09-25 |
| 1821431206 | Lanell Staroba | Pharmacist | 706 D 38th St, Fargo, ND 58102 | 2013-04-16 |
| Find all providers in zip 58102 | ||||
| Taxonomy Code | 2084N0400X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Neurology |
| A Neurologist specializes in the diagnosis and treatment of diseases or impaired function of the brain, spinal cord, peripheral nerves, muscles, autonomic nervous system, and blood vessels that relate to these structures. |
| Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720095482 | Kevin Michael Faber | Psychiatry & Neurology | 2801 S University Dr, Fargo, ND 58103 | 2006-08-02 |
| 1730141466 | Edgardo Abad Crisostomo | Psychiatry & Neurology | 5225 23rd Ave S, Fargo, ND 58104 | 2006-04-06 |
| 1437590577 | Alexandra Sequeira | Psychiatry & Neurology | 700 1st Ave S, Fargo, ND 58103-1802 | 2013-07-16 |
| 1235423393 | Scott M. Belliston | Psychiatry & Neurology | 700 1st Ave S, Fargo, ND 58103-1802 | 2011-06-07 |
| 1225358906 | Sunil Anand Mutgi | Psychiatry & Neurology | 5225 23rd Ave S, Fargo, ND 58104-7927 | 2010-06-04 |
| 1265674873 | Michael David Manchak | Psychiatry & Neurology | 700 1st Ave S, Fargo, ND 58103-1802 | 2009-03-27 |
| 1053573287 | Ravinda Samaraweera | Psychiatry & Neurology | 700 1st Ave S, Fargo, ND 58103-1802 | 2008-06-29 |
| 1407017882 | Eugeniu V Muntean | Psychiatry & Neurology | 700 1st Ave S, Fargo, ND 58103-1802 | 2008-06-19 |
| 1609051242 | Paulina Justyna Kunecka | Psychiatry & Neurology | 3000 32nd Ave S, Fargo, ND 58103-6132 | 2008-01-02 |
| 1710160379 | Kara Denae Eickman | Psychiatry & Neurology | 700 1st Ave S, Fargo, ND 58103-1802 | 2007-12-06 |
| Find all providers in FARGO | ||||
Please comment or provide details below to improve the information on DR. DONALD MELVIN LARSON.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.