| Ambereen Alam, MD | |
| 1200 S Columbia Rd, Grand Forks, ND 58201 | |
| (701) 780-5000 | |
| (618) 876-0807 | 
| Full Name | Ambereen Alam | 
|---|---|
| Gender | Female | 
| Speciality | Pediatrics | 
| Location | 1200 S Columbia Rd, Grand Forks, North Dakota | 
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. | 
| Identifier | Type | State | Issuer | 
|---|---|---|---|
| 1841483492 | NPI | - | NPPES | 
| 036114367 | Medicaid | IL | 
| Taxonomy | Type | License (State) | Status | 
|---|---|---|---|
| 208000000X | Pediatrics | 18869 (North Dakota) | Primary | 
| 208000000X | Pediatrics | 036114367 (Illinois) | Secondary | 
| Entity Name | Centracare Clinic | 
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice | 
| Entity Identifiers | NPI Number: 1043212665 PECOS PAC ID: 2466363395 Enrollment ID: O20031105000293 | 
| Mailing Address | Practice Location Address | 
|---|---|
| Ambereen Alam, MD 2401 Demers Ave, Grand Forks, ND 58201 Ph: (701) 780-1891 | Ambereen Alam, MD 1200 S Columbia Rd, Grand Forks, ND 58201 Ph: (701) 780-5000 | 
| Dr. Jennifer M Peterson, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 1380 S Columbia Rd - Altru Family Medicine Center, Grand Forks, ND 58201 Phone: 701-795-2000 Fax: 701-780-1896 | |
| Lori A Sondrol, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 1380 S Columbia Rd - Altru Family Medical Center, Grand Forks, ND 58201 Phone: 701-795-2000 | |
| Mr. Miltiadis Douvoyiannis, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 1380 S Columbia Rd, Grand Forks, ND 58201 Phone: 701-795-2000 Fax: 701-780-4477 | |
| Bernard Jerome Hoggarth, MD Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 1000 S Columbia Road, Grand Forks, ND 58206 Phone: 701-780-5000 Fax: 701-780-1942 | |
| Susan K Zelewski, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 1380 S Columbia Rd - Altru Family Medicine Center, Grand Forks, ND 58201 Phone: 701-795-2000 | |
| Dr. Nicole Marie Zimmerman, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 1380 S Columbia Rd, Grand Forks, ND 58201 Phone: 701-795-2000 | |
| Mrs. Gloria A Adjekum, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 1380 S Columbia Rd - Altru Family Medicine Center, Grand Forks, ND 58201 Phone: 701-795-2000 Fax: 212-939-4022 |