Provider Demographics
NPI:1952359903
Name:STOE, ANNE HENRY (MD)
Entity Type:Individual
Prefix:DR
First Name:ANNE
Middle Name:HENRY
Last Name:STOE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:94 25TH AVE N
Mailing Address - Street 2:
Mailing Address - City:FARGO
Mailing Address - State:ND
Mailing Address - Zip Code:58102-2037
Mailing Address - Country:US
Mailing Address - Phone:701-241-4413
Mailing Address - Fax:
Practice Address - Street 1:2624 9TH AVE SW
Practice Address - Street 2:SOUTHEAST HUMAN SERVICE CENTER
Practice Address - City:FARGO
Practice Address - State:ND
Practice Address - Zip Code:58103
Practice Address - Country:US
Practice Address - Phone:701-298-4500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-04
Last Update Date:2013-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND46052084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
ND17178Medicaid
NDN711979Medicare PIN