PHILIP M. WANZEK (NPI# 1326301250) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1326301250 |
| Entity Type | Individual |
| Full Name | PHILIP M. WANZEK |
| Credential | DO |
| Practice Address |
3000 32nd Ave S Fargo ND 58103-6132 |
| Mailing Address |
1702 University Dr S Fargo ND 58103-4940 |
| Practice Telephone | 7013648000 |
| Mailing Telephone | (701) 364-4222 |
| Enumeration Date | 2012-06-15 |
| Last Update Date | 2018-03-17 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208800000X | Urology | 14669 | ND | Allopathic & Osteopathic Physicians |
| N | 208800000X | Urology | 56768 | MN | Allopathic & Osteopathic Physicians |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 200 1st St Sw, Rochester, MN 559050001 | 5072842511 |
| Street Address |
3000 32ND AVE S |
| City | FARGO |
| State | ND |
| Zip Code | 58103-6132 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073506648 | Randy K Metcalf | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 3000 32nd Ave S, Fargo, ND 58103-6132 | 2005-08-29 |
| 1861006504 | Hallie M Tiffany | Nurse Practitioner | 3000 32nd Ave S, Fargo, ND 58103-6132 | 2020-09-01 |
| 1144846452 | Andrea Patrice Solberg | Nurse Practitioner | 3000 32nd Ave S, Fargo, ND 58103-6132 | 2020-06-23 |
| 1669098976 | Nathaniel James Piersol | Nurse Anesthetist, Certified Registered | 3000 32nd Ave S, Fargo, ND 58103-6132 | 2020-06-23 |
| 1710503545 | Emily Olivia Miranda | Nurse Practitioner | 3000 32nd Ave S, Fargo, ND 58103-6132 | 2020-06-17 |
| 1619500642 | Collin Docter | Physical Therapist | 3000 32nd Ave S, Fargo, ND 58103-6132 | 2020-02-18 |
| 1386276863 | Corey David Bos | Nurse Anesthetist, Certified Registered | 3000 32nd Ave S, Fargo, ND 58103-6132 | 2020-02-12 |
| 1619508587 | Stephanie Lee Piirainen | Student in an Organized Health Care Education/Training Program | 3000 32nd Ave S, Fargo, ND 58103-6132 | 2020-01-30 |
| 1386274918 | Melissa Ann Knopik | Nurse Practitioner | 3000 32nd Ave S, Fargo, ND 58103-6132 | 2020-01-23 |
| 1205475126 | Jerika A Decker | Physician Assistant | 3000 32nd Ave S, Fargo, ND 58103-6132 | 2019-12-23 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659924843 | Amanda Hericks | Dentist | 1338 Gateway Drive S, Fargo, ND 58103 | 2019-07-17 |
| 1285298240 | Ann Louise Breen | Optometrist | Sanford Southpointe Eye Center & Optical, 2400 32nd Ave. S., Fargo, ND 58103 | 2019-04-25 |
| 1245706597 | Lisa Elaine Livingston | Counselor | 1337 14 and Half St. S., Fargo, ND 58103 | 2018-10-15 |
| 1528569662 | Misty Lynn Hagen | Counselor | 901 28th St. South, Suite B, Fargo, ND 58103 | 2018-02-23 |
| 1083133011 | Faith Homecare Professionals LLC | Home Health | 304 25th St S, Suite B, Fargo, ND 58103 | 2017-09-11 |
| 1982138749 | Matthew Troyer | Pharmacist | 2425 13th Ave, Fargo, ND 58103 | 2017-04-18 |
| 1801338504 | Amy Nguyen Christianson | Chiropractor | 1650 45th St S Ste 113, Fargo, ND 58103 | 2016-11-11 |
| 1245772359 | Andrea Marie Hanson | Nurse Practitioner | 2400 32nd Ave South, Fargo, ND 58103 | 2016-11-07 |
| 1831647940 | Abigail Carmen Burkett Vetter | Nurse Practitioner | 2928 University Dr S Suite 101, Fargo, ND 58103 | 2016-09-18 |
| 1013361302 | Nancy Knowlton | Speech-Language Pathologist | 3001 11th Ave S, Beyond Boundaries Speech-language, Fargo, ND 58103 | 2016-04-22 |
| Find all providers in zip 58103 | ||||
| Taxonomy Code | 208800000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Urology |
| A urologist manages benign and malignant medical and surgical disorders of the genitourinary system and the adrenal gland. This specialist has comprehensive knowledge of and skills in endoscopic, percutaneous and open surgery of congenital and acquired conditions of the urinary and reproductive systems and their contiguous structures. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added] Additional Resources: American Board of Urology, 2007. http://www.abu.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Urology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831519388 | Archana Rajender | Urology | 3000 32nd Ave S, Fargo, ND 58103-6132 | 2014-04-23 |
| 1295179687 | Eric Andrew Schommer | Urology | 801 Broadway N, Fargo, ND 58102 | 2013-04-29 |
| 1710125893 | Brent Richard Williams | Urology | 801 Broadway N, Fargo, ND 58102-3641 | 2009-01-28 |
| 1124218664 | Samy Mamdouh Mohamed Heshmat | Urology | 801 Broadway N, Fargo, ND 58102-3641 | 2007-07-31 |
| 1629090261 | Theodore J Sawchuk | Urology | 801 Broadway N, Fargo, ND 58102-3641 | 2006-07-24 |
| 1578585121 | Michael D Segal | Urology | 801 Broadway N, Fargo, ND 58102-3641 | 2006-07-24 |
| 1720005275 | Thomas A Noah | Urology | 801 Broadway N, Fargo, ND 58102-3641 | 2006-07-17 |
| 1023049129 | Conrad R Toni | Urology | 801 Broadway N, Fargo, ND 58102-3641 | 2006-07-06 |
| 1639108814 | Steven P Strinden | Urology | 3000 32nd Ave S, Fargo, ND 58103-6132 | 2006-07-01 |
| 1447288261 | Kristina L Garrels | Urology | 801 Broadway N, Fargo, ND 58102-3641 | 2006-06-29 |
| Find all providers in FARGO | ||||
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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.