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NPI Code Detail

MEDICARE: PATRICK SAFO MD PHD

MEDICARE: PATRICK SAFO MD PHD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1390200000XStudent in an Organized Health Care Education/Training ProgramMD
2207N00000XDermatology Physician56518-20WI

General Provider Information

NPI Number : 1104088202
Entity Type Code : Individual
Provider Name (Legal Business Name) : PATRICK SAFO MD PHD
Provider Business Mailing Address
First Line : 211 SIOUX POINT RD STE 200
Second Line :
City : DAKOTA DUNES
State : SD
Zip : 57049-5492
Country : US
Telephone Number : 605-422-3000
Fax Number : 605-422-3001
Provider Business Practice Location Address
First Line : 824 ILLINOIS AVE
Second Line :
City : STEVENS POINT
State : WI
Zip : 54481-3112
Country : US
Telephone Number : 715-342-7500
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/30/2008
Last Update Date : 03/12/2026

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