| Plains Medical Clinic, Llc | |
|
3290 20th St S Fargo ND 58104-5923 | |
| (701) 499-4800 | |
| (701) 451-9452 |
| Full Name | Plains Medical Clinic, Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 3290 20th St S, Fargo, North Dakota |
| Authorized Official Name and Position | Margaret Gilbertson (PRACTICE MANAGER) |
| Authorized Official Contact | 7014994807 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Plains Medical Clinic, Llc 3290 20th St S Fargo ND 58104-5923 Ph: (701) 499-4800 | Plains Medical Clinic, Llc 3290 20th St S Fargo ND 58104-5923 Ph: (701) 499-4800 |
| NPI Number | 1073698460 |
|---|---|
| Provider Enumeration Date | 10/26/2006 |
| Last Update Date | 05/29/2013 |
| Medicare PECOS PAC ID | 5890787170 |
|---|---|
| Medicare Enrollment ID | O20040330001055 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1073698460 | NPI | - | NPPES |
| 569500002 | Other | ND | DME |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| 332B00000X | Durable Medical Equipment & Medical Supplies | (North Dakota) | Secondary |
| Provider Name | Hoadley H Harris |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1811991607 PECOS PAC ID: 3375535651 Enrollment ID: I20040330001097 |
| Provider Name | Joel F Schock |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1790789576 PECOS PAC ID: 0244222438 Enrollment ID: I20040330001220 |
| Provider Name | Huyen N Buegel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1982983789 PECOS PAC ID: 5294907275 Enrollment ID: I20111017000792 |
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