Provider Demographics
NPI:1851370704
Name:FOLK, HEIDI M (MPT)
Entity type:Individual
Prefix:
First Name:HEIDI
Middle Name:M
Last Name:FOLK
Suffix:
Gender:F
Credentials:MPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1100 WEISS AVE
Mailing Address - Street 2:
Mailing Address - City:BISMARCK
Mailing Address - State:ND
Mailing Address - Zip Code:58503-0539
Mailing Address - Country:US
Mailing Address - Phone:701-222-1300
Mailing Address - Fax:701-222-2166
Practice Address - Street 1:1100 WEISS AVE
Practice Address - Street 2:
Practice Address - City:BISMARCK
Practice Address - State:ND
Practice Address - Zip Code:58503-0539
Practice Address - Country:US
Practice Address - Phone:701-222-1300
Practice Address - Fax:701-222-2166
Is Sole Proprietor?:No
Enumeration Date:2006-01-10
Last Update Date:2010-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND1263174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
ND26179OtherBCBS
ND54020Medicaid
ND711614Medicare ID - Type Unspecified