DR. MARK DOMAAS


Address: 4450 31st Ave S, Ste 102, Fargo, ND 58104-4557
Phone: 7015668721

DR. MARK DOMAAS (NPI# 1265845010) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1265845010
Entity Type Individual
Full Name DR. MARK DOMAAS
Credential DPM
Practice Address 4450 31st Ave S
Ste 102
Fargo
ND 58104-4557
Mailing Address 4450 31st Ave S Ste 102
Fargo
ND 58104-4557
Practice Telephone 7015668721
Practice Fax Number 7012054593
Mailing Telephone 7015613312
Mailing Fax Number 7012325578
Enumeration Date 2014-06-10
Last Update Date 2020-04-28
Gender Code M
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
N 213E00000X Podiatrist 016005716 IL Podiatric Medicine & Surgery Service Providers
Y 213E00000X Podiatrist 82 ND Podiatric Medicine & Surgery Service Providers

Office Location

Street Address 4450 31ST AVE S
STE 102
City FARGO
State ND
Zip Code 58104-4557

Providers in the same location

NPI Name Taxonomy Address Enumeration
1396184859 Nicholas Steven Adams Plastic Surgery 4450 31st Ave S, Ste 102, Fargo, ND 58104-4557 2013-06-18

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1043837347 Pinnacle Therapy & Wellness, Pllc Physical Therapist 4500 36th Ave S Suite 100, Fargo, ND 58104 2020-07-02
1619509858 Patricia Helen Bathie Counselor 4243 Auburn Ave., Fargo, ND 58104 2020-02-05
1346892866 Elizabeth Olis Registered Nurse 2633 55th St. S, Apartment 202, Fargo, ND 58104 2019-07-15
1780247023 Keith Kirimi Ndege Physical Therapy Assistant 5225 23rd Ave South, Fargo, ND 58104 2019-04-22
1346728557 Ms4 Pllc Pharmacy 4476 31st Avenue South, Suite #105, Fargo, ND 58104 2018-07-31
1891286977 Jessica Rae Majidian Dentist 3030 49th St S, Fargo, ND 58104 2018-05-23
1821588500 Alissa Nichole Larson Pharmacist 5675 26th Ave S St. 136a, Fargo, ND 58104 2018-05-17
1790297430 Northern Lights Dental Dentist 4150 19th Ave S, Suite 301, Fargo, ND 58104 2017-11-03
1619406733 Cobalt Rehabilitation Hospital Fargo LLC Rehabilitation Hospital 4671 38th Street S, Fargo, ND 58104 2017-06-12
1790210318 Homefield Health, LLC Clinic/Center 4141 31st Ave S., Ste 102, Fargo, ND 58104 2017-04-21
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Taxonomy Information

Taxonomy Code 213E00000X
Grouping Podiatric Medicine & Surgery Service Providers
Classification Podiatrist

Taxonomy Definition

A podiatrist is a person qualified by a Doctor of Podiatric Medicine (D.P.M.) degree, licensed by the state, and practicing within the scope of that license. Podiatrists diagnose and treat foot diseases and deformities. They perform medical, surgical and other operative procedures, prescribe corrective devices and prescribe and administer drugs and physical therapy.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1114453552 Derek Anthony Mclister Podiatrist 5225 23rd Ave S, Fargo, ND 58104-7927 2017-05-04
1255505004 A Foot Doctor, Pllc Podiatrist 2631 12th Ave S, Fargo, ND 58103-8741 2008-04-14
1649298381 Brad C Anderson Podiatrist 2400 32nd Ave S, Fargo, ND 58103-5800 2006-07-18
1902824600 Richard E Arness Podiatrist 2400 32nd Ave S, Fargo, ND 58103-5800 2006-07-18
1972534642 Lee A Hofsommer Podiatrist 1702 University Dr S, Fargo, ND 58103-4940 2006-07-05

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1902933401 Richard Gary Mason Podiatrist 3883 74th St. N.e., 3883 74th St. N.e., Fort Totten, ND 58335-0309 2007-02-28
1942341086 Nathan Richard Randall Podiatrist 1 Main Hospital Road, Box 160, Belcourt, ND 58316-0160 2007-02-10
1386654424 Jessica Anne Bentson Podiatrist 525 N 9th St, Bismarck, ND 58501-4510 2006-08-09
1336173871 Basem Fanous Podiatrist Hwy 281n, Cando, ND 58324-0688 2006-07-10
1518965276 Cherian Mathew Podiatrist 2215 Sims St, Dickinson, ND 58601-6521 2005-07-07
1992206528 Elbowoods Memorial Health Center Podiatrist 1058 College Dr, New Town, ND 58763-9112 2018-02-28
1184010969 Adam Finzen Podiatrist 4440 S Washington St - Altru Professional Center, Grand Froks, ND 58201-7245 2015-04-08
1659788164 Kayla Marie Emter Podiatrist 2422 20th St Sw, Jamestown, ND 58401-6201 2014-07-16
1407111321 Andrew Dean Knudsen Podiatrist 401 N 9th St, Bismarck, ND 58501-4530 2012-07-06
1326306630 Burkley Jensen Podiatrist 300 N 7th St, Bismarck, ND 58501 2012-04-25
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Competitor

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City FARGO
Zip Code 58104

Improve Information

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Dataset Information

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.

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