| Upper Midwest Tms Llc | |
|
5621 36th Ave S Unit 300 Fargo ND 58104-5270 | |
| (701) 532-1060 | |
| Not Available |
| Full Name | Upper Midwest Tms Llc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 5621 36th Ave S Unit 300, Fargo, North Dakota |
| Authorized Official Name and Position | Joel Schock (OWNER) |
| Authorized Official Contact | 7013711072 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Upper Midwest Tms Llc 5630 34th Ave S Ste 120 Fargo ND 58104-7885 Ph: (701) 371-5576 | Upper Midwest Tms Llc 5621 36th Ave S Unit 300 Fargo ND 58104-5270 Ph: (701) 532-1060 |
| NPI Number | 1770173643 |
|---|---|
| Provider Enumeration Date | 01/24/2021 |
| Last Update Date | 02/21/2024 |
| Certification Date | 02/21/2024 |
| Medicare PECOS PAC ID | 3274937362 |
|---|---|
| Medicare Enrollment ID | O20210811003634 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1770173643 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Primary |
| Provider Name | Joel F Schock |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1790789576 PECOS PAC ID: 0244222438 Enrollment ID: I20040330001220 |
| Provider Name | Jonathan C Olivas |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1942599048 PECOS PAC ID: 5698918977 Enrollment ID: I20150812009286 |
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