Healthcare Provider Details

I. General information

NPI: 1881615318
Provider Name (Legal Business Name): STEPHEN A KORTE MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/21/2006
Last Update Date: 03/20/2025
Certification Date: 03/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1300 S COLUMBIA RD
GRAND FORKS ND
58201
US

IV. Provider business mailing address

122 E COLLEGE AVE
APPLETON WI
54911-5741
US

V. Phone/Fax

Practice location:
  • Phone: 701-780-2300
  • Fax: 830-768-9254
Mailing address:
  • Phone: 920-996-3264
  • Fax: 920-830-5910

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RI0011X
TaxonomyInterventional Cardiology Physician
License NumberR7023
License Number StateMO
# 2
Primary TaxonomyN
Taxonomy Code207RI0011X
TaxonomyInterventional Cardiology Physician
License Number25839
License Number StateWI
# 3
Primary TaxonomyY
Taxonomy Code207RI0011X
TaxonomyInterventional Cardiology Physician
License NumberMD61264609
License Number StateWA
# 4
Primary TaxonomyN
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number29077
License Number StateMN
# 5
Primary TaxonomyN
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number10747
License Number StateND

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: