Provider Demographics
NPI:1255363693
Name:DEES, BRIAN K (MD)
Entity type:Individual
Prefix:
First Name:BRIAN
Middle Name:K
Last Name:DEES
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 6001
Mailing Address - Street 2:
Mailing Address - City:FARGO
Mailing Address - State:ND
Mailing Address - Zip Code:58108-6001
Mailing Address - Country:US
Mailing Address - Phone:701-364-3300
Mailing Address - Fax:701-364-8906
Practice Address - Street 1:3000 32ND AVE S
Practice Address - Street 2:
Practice Address - City:FARGO
Practice Address - State:ND
Practice Address - Zip Code:58103-6132
Practice Address - Country:US
Practice Address - Phone:701-364-8000
Practice Address - Fax:701-364-8078
Is Sole Proprietor?:No
Enumeration Date:2006-07-07
Last Update Date:2011-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND9323208600000X
MN45703208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
ND131617600Medicaid
ND1700987OtherMEDICA #
ND1805258OtherAMERICA'S PPO/ARAZ #
ND26365OtherNDBS #
ND358J8DEOtherMNBS #
NDHP38245OtherHEALTHPARTNERS #
ND23118OtherNDBS #
ND023H6DEOtherMNBS #
ND12287Medicaid
ND137006OtherUCARE #
ND170554OtherMEDICA #
ND1700988OtherMEDICA #
NDDA9011034038OtherPREFERRED ONE #
ND1700987OtherMEDICA #
ND170554OtherMEDICA #
ND711759Medicare ID - Type UnspecifiedND MEDICARE #
ND23118OtherNDBS #