Ajit S Damle, MD

Primary specialty

Vascular Surgery PhysicianTaxonomy code 2086S0129X

License

5835 Issued in ND

Practice address

737 Broadway
Fargo, ND 58122-0001

Phone

(701) 234-2576

Fax

(701) 234-3769

NPI assigned

Jul 16, 2006

Last updated

Oct 20, 2008By the provider in NPPES

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Frances Mahon Deaconess Hospital

  • Critical Access Hospital
  • Glasgow, MT
  • NPI 1689685323
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1153008000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1224460800000",
    "number": "1972520831",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "737 BROADWAY",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581220001",
            "telephone_number": "701-234-2576",
            "fax_number": "701-234-3769"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "737 BROADWAY",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581220001",
            "telephone_number": "701-234-2576",
            "fax_number": "701-234-3769"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAMLE",
        "first_name": "AJIT",
        "middle_name": "S",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-16",
        "last_updated": "2008-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "ND",
            "license": "5835",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "16266",
            "state": "ND"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "288297300",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Danilo Antonio Dalan, MD
• Andrew Lee Dalberg
• Cassandra Vanasse Dale, MSW, LCSW
• Megan Maria Dallman, CRNA
• Damen Pathway Health Wheels
• Andrea Damm
• Tara Michelle Dammer, PHARMD
• Christopher Danduran, D.C.
• Shawna A Danduran, MSW
• Jonathan Dandurand

• Vascular Surgery Physician in Fargo, ND
• Providers in Fargo, ND by specialty
• Vascular Surgery Physician in North Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.