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Individual

MICHELLE A WYATT

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
3000 32ND AVE S, FARGO, ND 58103-6132
(701) 364-8000
Mailing address
1702 UNIVERSITY DR S, FARGO, ND 58103-4940

Taxonomy

Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
59430
MN
207VM0101X
Maternal & Fetal Medicine Physician
Primary
17243
ND
207VM0101X
Maternal & Fetal Medicine Physician
59430
MN

Other

Enumeration date
07/01/2014
Last updated
08/30/2021
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