Individual
MR. RICHARD WAKEFIELD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2514 S WASHINGTON ST, GRAND FORKS, ND 58201-6776
(701) 746-7000
(701) 746-5220
Mailing address
2514 S WASHINGTON ST, GRAND FORKS, ND 58201-6776
(701) 746-7000
(701) 746-5220
Taxonomy
Speciality
Code
Description
License number
State
237700000X
Hearing Instrument Specialist
Primary
H-0063
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
24303
BLUE CROSS & BLUE SHIELD
ND
05
—
548065500
—
MN
05
—
57635
—
ND
01
—
7G771WA
BLUE CROSS & BLUE SHIELD
MN
Enumeration date
05/02/2008
Last updated
05/02/2008
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