MARK E DOMAAS LLC (NPI# 1720633373) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1720633373 |
| Entity Type | Organization |
| Organization Name | MARK E DOMAAS LLC |
| Other Organization Name | ADVANCED FOOT & ANKLE |
| Practice Address |
4450 31st Ave S Ste 102 Fargo ND 58104-4557 |
| Practice Telephone | 7632184771 |
| Practice Fax Number | 7012054593 |
| Mailing Telephone | 7015613312 |
| Mailing Fax Number | 7012325578 |
| Enumeration Date | 2019-08-09 |
| Last Update Date | 2020-04-28 |
| Authorized Official Name | DR. MARK EDWARD DOMAAS (PRESIDENT) |
| Authorized Official Telephone | 7015613312 |
| Authorized Official Credential | DPM |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 213EP1101X |
Podiatrist Specialization: Primary Podiatric Medicine |
Podiatric Medicine & Surgery Service Providers |
| Other Name | Type Code |
|---|---|
| Advanced Foot & Ankle | Other Name - Individual/Organization |
| Fargo Foot and Ankle | Other Name - Individual/Organization |
| Street Address |
4450 31ST AVE S STE 102 |
| City | FARGO |
| State | ND |
| Zip Code | 58104-4557 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245286988 | Brent M Hella | Internal Medicine | 4450 31st Ave S Ste 102, Fargo, ND 58104-4557 | 2006-05-25 |
| 1265065668 | Center for Plastic Surgery | Plastic Surgery | 4450 31st Ave S Ste 102, Fargo, ND 58104-4557 | 2020-02-14 |
| 1144313743 | Internal Medicine Associates Inc | Internal Medicine | 4450 31st Ave S Ste 102, Fargo, ND 58104-4557 | 2006-10-02 |
| 1174541874 | Steven Glenn Clemenson | Internal Medicine | 4450 31st Ave S Ste 102, Fargo, ND 58104-4557 | 2006-07-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043837347 | Pinnacle Therapy & Wellness, Pllc | Physical Therapist | 4500 36th Ave S Suite 100, Fargo, ND 58104 | 2020-07-02 |
| 1619509858 | Patricia Helen Bathie | Counselor | 4243 Auburn Ave., Fargo, ND 58104 | 2020-02-05 |
| 1346892866 | Elizabeth Olis | Registered Nurse | 2633 55th St. S, Apartment 202, Fargo, ND 58104 | 2019-07-15 |
| 1780247023 | Keith Kirimi Ndege | Physical Therapy Assistant | 5225 23rd Ave South, Fargo, ND 58104 | 2019-04-22 |
| 1346728557 | Ms4 Pllc | Pharmacy | 4476 31st Avenue South, Suite #105, Fargo, ND 58104 | 2018-07-31 |
| 1891286977 | Jessica Rae Majidian | Dentist | 3030 49th St S, Fargo, ND 58104 | 2018-05-23 |
| 1821588500 | Alissa Nichole Larson | Pharmacist | 5675 26th Ave S St. 136a, Fargo, ND 58104 | 2018-05-17 |
| 1790297430 | Northern Lights Dental | Dentist | 4150 19th Ave S, Suite 301, Fargo, ND 58104 | 2017-11-03 |
| 1619406733 | Cobalt Rehabilitation Hospital Fargo LLC | Rehabilitation Hospital | 4671 38th Street S, Fargo, ND 58104 | 2017-06-12 |
| 1790210318 | Homefield Health, LLC | Clinic/Center | 4141 31st Ave S., Ste 102, Fargo, ND 58104 | 2017-04-21 |
| Find all providers in zip 58104 | ||||
| Taxonomy Code | 213EP1101X |
| Grouping | Podiatric Medicine & Surgery Service Providers |
| Classification | Podiatrist |
| Specialization | Primary Podiatric Medicine |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700043528 | Benjamin Felty | Podiatrist | 401 3rd St Se, Jamestown, ND 58401-4247 | 2008-05-20 |
Please comment or provide details below to improve the information on MARK E DOMAAS LLC.
| 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.