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Contact Information

DEBRA ANDVIK, PAC
3280 20TH ST S
FARGO, ND58104-5917
 Phone: 701-499-4800
 Fax: 701-451-9452
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Medical

363AM0700X 97 Physician Assistant
Indicates primary specialty

NPI Profile & details for DEBRA ANDVIK · (Female)

NPI # 1821172404
Status Active
Credentials PAC
Entity Individual
Enumeration date 10/24/2006
Last updated 03/04/2009 - About 17 years ago
Sole proprietor 1 No
Identifiers
  • ND License # PAC0194
  • MN Medicaid 048592600
  • ND Medicaid 16541
  • MN Other 212K9AN MNBS
  • ND Other 024067 NDBS
  • ND Other P00189293 RAILROAD MEDICARE
Hospital affiliation(s)
  • ESSENTIA HEALTH-FARGO - (Acute Care)
    3000 32ND AVE SOUTH
    FARGO, ND 58104
  • SANFORD MEDICAL CENTER FARGO - (Acute Care)
    801 BROADWAY NORTH
    FARGO, ND 58122
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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