WALLACE E RADTKE MD NPI 1134140353

NPI Information

NPI: 1134140353
Provider Name: WALLACE E RADTKE, MD
Classification: Internal Medicine - 207RC0000X
Entity Type: Individual

Specialization: Cardiovascular Disease

Address:
801 BROADWAY N
FARGO, ND
ZIP 58102
Phone: (701) 234-2371
Get Directions

Wallace E Radtke, MD is a cardiovascular disease internal medicine in Fargo, ND. The provider is an internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms. Wallace E Radtke, MD NPI is 1134140353. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

801 BROADWAY N
FARGO, ND
ZIP 58102-641
Phone: (701) 234-2371
Fax: (701) 234-3813

The enumeration date for this NPI number is 7/22/2006 and was last updated on 5/2/2012.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	207RC0000X	Internal Medicine	Cardiovascular Disease	3798	NORTH DAKOTA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State
1	N1318	MEDICARE PIN	NORTH DAKOTA
2	D26226	MEDICARE UPIN
3	060001722	MEDICARE PIN	MINNESOTA
4	12479	MEDICAID	NORTH DAKOTA
5	258285600	MEDICAID	MINNESOTA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.

« Previous NPI

Next NPI »