Basic Information
Provider Information
NPI: 1558589994
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: NORBY
FirstName: ALICIA
MiddleName: MARIE
NamePrefix:  
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 5010
Address2:  
City: MINOT
State: ND
PostalCode: 587025010
CountryCode: US
TelephoneNumber: 7018575000
FaxNumber:  
Practice Location
Address1: 1 BURDICK EXPY W
Address2:  
City: MINOT
State: ND
PostalCode: 587014406
CountryCode: US
TelephoneNumber: 7018575000
FaxNumber: 7018573576
Other Information
ProviderEnumerationDate: 04/23/2007
LastUpdateDate: 07/28/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 07/28/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207R00000X57012001OHN Allopathic & Osteopathic PhysiciansInternal Medicine 
208M00000X11377NDN Allopathic & Osteopathic PhysiciansHospitalist 
207R00000X11377NDY Allopathic & Osteopathic PhysiciansInternal Medicine 

No ID Information.


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