DONALD R. GULLICKS (NPI# 1619288602) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1619288602 |
| Entity Type | Individual |
| Full Name | DONALD R. GULLICKS |
| Credential | MD |
| Practice Address |
4000 28th Ave S Moorhead MN 56560-7926 |
| Mailing Address |
Po Box 2168 Fargo ND 58107-2168 |
| Practice Telephone | 7012343200 |
| Practice Fax Number | 7012343239 |
| Mailing Telephone | 7012342119 |
| Enumeration Date | 2010-06-24 |
| Last Update Date | 2014-10-22 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207V00000X | Obstetrics & Gynecology | 13170 | ND | Allopathic & Osteopathic Physicians |
| Y | 207V00000X | Obstetrics & Gynecology | TP107788 | MN | Allopathic & Osteopathic Physicians |
| N | 207V00000X | Obstetrics & Gynecology | 2010020741 | MO | Allopathic & Osteopathic Physicians |
| Street Address |
4000 28TH AVE S |
| City | MOORHEAD |
| State | MN |
| Zip Code | 56560-7926 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124122783 | Sanford Clinic North | Durable Medical Equipment & Medical Supplies | 4000 28th Ave S, Moorhead, MN 56560 | 2006-09-12 |
| 1447772470 | Dustin Joel Czapiewski | Nurse Practitioner | 4000 28th Ave S, Moorhead, MN 56560-7926 | 2017-07-12 |
| 1568996700 | Alyson Dahl | Physician Assistant | 4000 28th Ave S, Moorhead, MN 56560-7926 | 2017-04-14 |
| 1568836781 | Courtney Jo Burgad | Social Worker | 4000 28th Ave S, Moorhead, MN 56560-7926 | 2015-11-27 |
| 1114314093 | Amy Joy Bro | Nurse Practitioner | 4000 28th Ave S, Moorhead, MN 56560-7926 | 2015-04-19 |
| 1073910253 | Laura Fugleberg | Physician Assistant | 4000 28th Ave S, Moorhead, MN 56560-7926 | 2014-12-03 |
| 1205240900 | Amanda Oney | Nurse Practitioner | 4000 28th Ave S, Moorhead, MN 56560 | 2014-06-20 |
| 1760801187 | Natalie Frances Dvorak | Pediatrics | 4000 28th Ave S, Moorhead, MN 56560-7926 | 2014-04-14 |
| 1093134462 | Kyra Decker | Nurse Practitioner | 4000 28th Ave S, Moorhead, MN 56560 | 2014-04-14 |
| 1083992002 | Samantha J Perleberg | Pediatrics | 4000 28th Ave S, Moorhead, MN 56560 | 2011-07-25 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386298859 | Anna Mckay Fox | Pharmacist | 4000 28th Avenue S, Moorhead, MN 56560 | 2019-08-01 |
| 1972019727 | Michael Wayne Hilliard | Specialist/Technologist | 649 17th St S, Moorhead, MN 56560 | 2017-12-15 |
| 1508217183 | Kristen Johnson | Nurse Practitioner | 801 Belsly Boulevard, Moorhead, MN 56560 | 2016-06-25 |
| 1861877052 | Midwest Mental Health Clinic | Nurse Practitioner | 819 30th Ave S Office 206 Suite B, Moorhead, MN 56560 | 2015-07-29 |
| 1083037709 | Drake Counseling Services, Inc. | Clinic/Center | 715 11th Street North, Suite 204, Moorhead, MN 56560 | 2014-01-31 |
| 1710310917 | Lamar Terrell Hill | Social Worker | 420 Center Ave Ste 102, Moorhead, MN 56560 | 2013-08-12 |
| 1982956140 | Lilac Homes Corporation | Assisted Living Facility | 2615 Parkview Dr, Moorhead, MN 56560 | 2012-10-11 |
| 1487918462 | Paige Joy Hanson | Massage Therapist | 805 14th St. So., Msum Wellness Center, Moorhead, MN 56560 | 2012-06-25 |
| 1972809408 | Cslm, LLC | Assisted Living Facility | 2401 South 11th Street, Moorhead, MN 56560 | 2011-02-01 |
| 1972814846 | Paul Michael Fluto | Pharmacist | 3000 Hwy 10 East, Mooehead, MN 56560 | 2010-06-25 |
| Find all providers in zip 56560 | ||||
| Taxonomy Code | 207V00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Obstetrics & Gynecology |
| An obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Obstetrics and Gynecology, 2007. http://www.abog.org/. American Osteopathic Board of Obstetrics and Gynecology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Obstetrics and Gynecology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Obstetrics and Gynecology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316581218 | Catherine Pamela Edwards | Obstetrics & Gynecology | 7048 Highover Ct S, Chanhassen, MN 55317-7569 | 2019-11-04 |
| 1407329139 | Arthur Joseph Horowitz | Obstetrics & Gynecology | 830 Edgemoor Dr, Hopkins, MN 55305-4852 | 2019-01-04 |
| 1710437967 | David Olson | Obstetrics & Gynecology | 8201 Creekside Cir, Bloomington, MN 55437-3836 | 2016-10-12 |
| 1326492182 | Leah Christine Henke | Obstetrics & Gynecology | 688 Holly Ave Apt 5, Saint Paul, MN 55104-7557 | 2016-04-19 |
| 1922402395 | Robert Ross Neal Jr. | Obstetrics & Gynecology | 7917 Wyoming Ct, Bloomington, MN 55438-1092 | 2014-10-14 |
| 1285052027 | Paige Persch | Obstetrics & Gynecology | 6565 France Ave S Ste 300, Edina, MN 55435-2154 | 2014-03-30 |
| 1386065100 | Jennifer Arnhold Md Plc | Obstetrics & Gynecology | 13359 Isle Dr. Suite 2, Baxter, MN 56425-2222 | 2013-12-20 |
| 1598008716 | Sarah Marie Krueger | Obstetrics & Gynecology | 606 24th Ave S Ste 700, Minneapolis, MN 55454-1462 | 2013-04-05 |
| 1922341791 | Matthew Thomas Bigos | Obstetrics & Gynecology | 14001 Ridgedale Dr Ste 200, Minnetonka, MN 55305-1747 | 2013-03-31 |
| 1205191335 | William F Dickes | Obstetrics & Gynecology | 14708 57th St S, Afton, MN 55001-9686 | 2012-07-04 |
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| 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.