RICHARD W BLAINE (NPI# 1942227947) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1942227947 |
| Entity Type | Individual |
| Full Name | RICHARD W BLAINE |
| Credential | MD |
| Practice Address |
737 Broadway N Fargo ND 58122-0001 |
| Mailing Address |
2400 32nd Ave S Fargo ND 58103-5800 |
| Practice Telephone | 7012344811 |
| Practice Fax Number | 7012346979 |
| Mailing Telephone | 7012348860 |
| Mailing Fax Number | 7012348924 |
| Enumeration Date | 2006-07-16 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207N00000X | Dermatology | 3003 | ND | Allopathic & Osteopathic Physicians |
| Street Address |
737 BROADWAY N |
| City | FARGO |
| State | ND |
| Zip Code | 58122-0001 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023040219 | Jerome I Thompson | Surgery | 737 Broadway N, Fargo, ND 58122-0001 | 2006-07-07 |
| 1376160184 | Michael Andrew Kerr | Family Medicine | 737 Broadway N, Fargo, ND 58102-4421 | 2020-06-26 |
| 1124645064 | Shelby Rae Bucholz | Family Medicine | 737 Broadway N, Fargo, ND 58102-4421 | 2020-06-26 |
| 1700431756 | Joshua Jacob Fisher | Family Medicine | 737 Broadway N, Fargo, ND 58102-4421 | 2019-08-06 |
| 1689229122 | Michael Seaman | Family Medicine | 737 Broadway N, Fargo, ND 58102-4421 | 2019-08-01 |
| 1467004838 | Fiona Lillian Axelsson | Family Medicine | 737 Broadway N, Fargo, ND 58102-4421 | 2019-07-15 |
| 1477115145 | Anuj Mogla | Family Medicine | 737 Broadway N, Fargo, ND 58102-4421 | 2019-07-02 |
| 1376105304 | Erika Singh | Family Medicine | 737 Broadway N, Fargo, ND 58102-4421 | 2019-06-29 |
| 1467947564 | Katrina Lee Foster | Family Medicine | 737 Broadway N, Fargo, ND 58102-4421 | 2018-06-30 |
| 1629590104 | Evelyn Fuentes-dondoneau | Family Medicine | 737 Broadway N, Fargo, ND 58102-4421 | 2017-07-17 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184142747 | Kayla Estepp | Internal Medicine | 737 Broadway North, Fargo, ND 58122 | 2017-09-05 |
| 1376091793 | Paul Mckay | Physical Therapist | 801 Broadway N., Fargo, ND 58122 | 2016-09-14 |
| 1801290150 | Mark Noah | Physical Therapist | 1720 South University, Fargo, ND 58122 | 2014-10-15 |
| 1245633486 | Diana Palm | Physical Therapist | 1720 University Drive South, Fargo, ND 58122 | 2014-10-02 |
| 1447696406 | Mohamad Imam | Internal Medicine | 801 Broadway North, Fargo, ND 58122 | 2013-05-17 |
| 1457615155 | Chantee Seung Gruenhagen | Nurse Practitioner | 737 North Broadway, Sanford Urology Clinic, Fargo, ND 58122 | 2012-06-27 |
| 1457594079 | Manisha Balhara | Specialist | 2400 32nd Avenue S, Fargo, ND 58122 | 2009-04-13 |
| 1578536728 | Shelby A Terstriep | Internal Medicine | 820 4 Street North, Fargo, NC 58122 | 2006-02-08 |
| 1295229946 | Christopher Hinh | Student in an Organized Health Care Education/Training Program | 801 Broadway North, Fargo, ND 58122 | 2018-06-17 |
| 1558854539 | Suchita Kotnala | Family Medicine | 737 Broadway North, Fargo, ND 58122 | 2018-06-13 |
| Find all providers in zip 58122 | ||||
| Taxonomy Code | 207N00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Dermatology |
| A dermatologist is trained to diagnose and treat pediatric and adult patients with benign and malignant disorders of the skin, mouth, external genitalia, hair and nails, as well as a number of sexually transmitted diseases. The dermatologist has had additional training and experience in the diagnosis and treatment of skin cancers, melanomas, moles and other tumors of the skin, the management of contact dermatitis and other allergic and nonallergic skin disorders, and in the recognition of the skin manifestations of systemic (including internal malignancy) and infectious diseases. Dermatologists have special training in dermatopathology and in the surgical techniques used in dermatology. They also have expertise in the management of cosmetic disorders of the skin such as hair loss and scars and the skin changes associated with aging. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source] Additional Resources: American Board of Dermatology, 2007. http://www.abderm.org/ Board certification is provided by the American Board of Dermatology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205031713 | Rachel C Ness | Dermatology | 3173 43rd Street S Ste A, Fargo, ND 58104-4564 | 2007-06-15 |
| 1902978455 | Beth A Honl | Dermatology | 4133 30th Ave S Ste 101, Fargo, ND 58104-8421 | 2006-11-13 |
| 1952408809 | Chetan P Maingi | Dermatology | 4556 40th Avenue South, Suite 130, Fargo, ND 58104 | 2006-09-20 |
| 1639121304 | Thomas J Matzke | Dermatology | 4656 40th Ave S, Fargo, ND 58104-4397 | 2006-05-17 |
| 1245223023 | Kimberly Rae Kelly | Dermatology | 1702 University Dr S, Fargo, ND 58103-4940 | 2005-08-26 |
| 1912359977 | Natalie Marie Kollman | Dermatology | 1702 University Dr S, Fargo, ND 58103-4940 | 2016-07-01 |
| 1043666274 | Dong Kim | Dermatology | 1702 University Dr S, Fargo, ND 58103-4940 | 2016-05-06 |
| 1225440324 | Ryan Bogner | Dermatology | 4656 40th Ave S, Fargo, ND 58104-4397 | 2014-05-22 |
| 1518247816 | Sanford Medical Center Fargo | Dermatology | 4656 40th Ave S, Fargo, ND 58104-4397 | 2011-08-18 |
| 1952539223 | Tania Marie Gonzalez Santiago | Dermatology | 4656 40th Ave S, Fargo, ND 58104-4397 | 2009-06-25 |
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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.