Provider Demographics
NPI:1245361450
Name:WAIND, MICHAEL JOHN (DC)
Entity type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:JOHN
Last Name:WAIND
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2506A S WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:GRAND FORKS
Mailing Address - State:ND
Mailing Address - Zip Code:58201-6703
Mailing Address - Country:US
Mailing Address - Phone:701-746-5477
Mailing Address - Fax:701-746-5479
Practice Address - Street 1:2506A S WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:GRAND FORKS
Practice Address - State:ND
Practice Address - Zip Code:58201-6703
Practice Address - Country:US
Practice Address - Phone:701-746-5477
Practice Address - Fax:701-746-5479
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-08
Last Update Date:2022-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND698171100000X, 111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
No171100000XOther Service ProvidersAcupuncturist
Provider Identifiers
StateIdentifier IDID TypeIssuer
ND81673Medicaid
MN886474800Medicaid
MN886474800Medicaid
ND21585Medicare ID - Type Unspecified
ND350054193Medicare ID - Type UnspecifiedRAILROAD MEDICARE