DR. MATTHEW EVERT WIISANEN (NPI# 1215945001) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1215945001 |
| Entity Type | Individual |
| Full Name | DR. MATTHEW EVERT WIISANEN |
| Credential | MD |
| Practice Address |
Sanford Heart Hospital 801 Broadway N Fargo ND 58122-0001 |
| Practice Telephone | 7012342371 |
| Practice Fax Number | 7012343411 |
| Mailing Telephone | 7012342371 |
| Mailing Fax Number | 7012343411 |
| Enumeration Date | 2006-08-04 |
| Last Update Date | 2016-06-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207R00000X | Internal Medicine | 12800 | ND | Allopathic & Osteopathic Physicians |
| N | 207R00000X | Internal Medicine | 42001 | KY | Allopathic & Osteopathic Physicians |
| N | 207RC0000X |
Internal Medicine Specialization: Cardiovascular Disease |
12800 | ND | Allopathic & Osteopathic Physicians |
| Y | 207RI0011X |
Internal Medicine Specialization: Interventional Cardiology |
12800 | ND | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MN | 176925100 | 05 |
| Street Address |
SANFORD HEART HOSPITAL 801 BROADWAY N |
| City | FARGO |
| State | ND |
| Zip Code | 58122-0001 |
| 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 | 207RI0011X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Interventional Cardiology |
| An area of medicine within the subspecialty of cardiology, which uses specialized imaging and other diagnostic techniques to evaluate blood flow and pressure in the coronary arteries and chambers of the heart and uses technical procedures and medications to treat abnormalities that impair the function of the cardiovascular system. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source] Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/ Board Certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. ACGME Accredited Residency Program Requirements: 1 year of training plus a prerequisite of 3 years Internal Medicine, 3 years Cardiovascular Disease for a total of 7 years. ABMS Approved Subspecialty Certificate (Internal Medicine) |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467585349 | Yassar Almanaseer | Internal Medicine | 5225 23rd Ave S, Fargo, ND 58104-7927 | 2007-03-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851565022 | Camelia Carmen Ilie | Internal Medicine | 222 N 7th St, Bismarck, ND 58501 | 2008-04-17 |
| 1578662433 | Robert Oatfield | Internal Medicine | 310 N 10th St, Bismarck, ND 58501-4516 | 2006-09-21 |
Please comment or provide details below to improve the information on DR. MATTHEW EVERT WIISANEN.
| 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.