Healthcare Provider Details

I. General information

NPI: 1922928506
Provider Name (Legal Business Name): ANDREW QUINN MEYER
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/15/2026
Last Update Date: 07/15/2026
Certification Date: 07/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1351 PAGE DR S STE 101
FARGO ND
58103-3502
US

IV. Provider business mailing address

323 7TH ST N
WAHPETON ND
58075-4231
US

V. Phone/Fax

Practice location:
  • Phone: 701-353-9979
  • Fax:
Mailing address:
  • Phone: 701-353-9979
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number1566-7-15-26A
License Number StateND

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: