Wenstrom, Timothy A
Wenstrom, Timothy A is an individual health care provider with primary practice located at 700 1St Ave S , Fargo ND 58103-1802. He recently has only one registered license in Allopathic & Osteopathic Physicians / Neurology, which is considered as his primary health care specialty. Wenstrom, Timothy A can be contacted via phone (701) 234-4086.Contact Information
Primary practice address
700 1St Ave S
Fargo ND 58103-1802
Phone: (701) 234-4086
Fax: (701) 234-4024
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Neurology | 2084N0400X | LP4423 | Minnesota |
Profile Details
| NPI number | 1326069667 |
|---|---|
| LBN Legal business name | Wenstrom, Timothy A |
| Credentials | PSYD |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 22nd, 2006 |
| Last updated | Oct 29th, 2008 - about 17 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1326069667 | NPPES |
| North Dakota | MEDICAID | 12155 | |
| North Dakota | MEDICAID | 764462100 |
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