Organization
MARK E DOMAAS LLC
Active
Other names
Advanced Foot & Ankle
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARK EDWARD DOMAAS DPM (PRESIDENT)
(701) 561-3312
Entity
Organization
Contact information
Practice address
4450 31ST AVE S STE 102, FARGO, ND 58104-4557
(763) 218-4771
(701) 205-4593
Mailing address
4450 31ST AVE S STE 102, FARGO, ND 58104-4557
(701) 561-3312
(701) 232-5578
Taxonomy
Speciality
Code
Description
License number
State
213EP1101X
Primary Podiatric Medicine Podiatrist
Primary
—
—
Other
Enumeration date
08/09/2019
Last updated
04/28/2020
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