Individual
PHILIP M. WANZEK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
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
(701) 364-4222
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
14669
ND
208800000X
Urology Physician
56768
MN
Other
Enumeration date
06/15/2012
Last updated
07/21/2022
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