Individual
WALDEMAR G STORM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
801 BROADWAY N, FARGO, ND 58102-3641
(701) 234-2261
(701) 234-7194
Mailing address
801 BROADWAY N, FARGO, ND 58102-3641
(701) 234-2261
(701) 234-7194
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
5336
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
15303
—
ND
05
—
574782100
—
MN
Enumeration date
07/24/2006
Last updated
05/02/2012
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