Provider Demographics
NPI:1336613009
Name:WHIRLWIND SOLDIER, ANTHONY ROBERT
Entity type:Individual
Prefix:
First Name:ANTHONY
Middle Name:ROBERT
Last Name:WHIRLWIND SOLDIER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1053 E MAIN ST APT 107
Mailing Address - Street 2:
Mailing Address - City:VALLEY CITY
Mailing Address - State:ND
Mailing Address - Zip Code:58072-3554
Mailing Address - Country:US
Mailing Address - Phone:701-680-7018
Mailing Address - Fax:
Practice Address - Street 1:101 COLLEGE ST SW
Practice Address - Street 2:
Practice Address - City:VALLEY CITY
Practice Address - State:ND
Practice Address - Zip Code:58072-4024
Practice Address - Country:US
Practice Address - Phone:701-845-7260
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-01-16
Last Update Date:2019-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program