Stephen C Wandersee in Bloomington - Physician Assistant
Stephen C Wandersee - NPI 1407822554
Stephen C Wandersee is a Physician Assistant in Bloomington, Minnesota. Stephen C Wandersee practices all healthcare services and medical treatments related to Physician Assistant. The NPI Number for Stephen C Wandersee is 1407822554. The last update date is 2015-03-24.
Stephen C Wandersee's current location address is 8100 34th Ave S, Bloomington, Minnesota. You can contact this provider via phone number 9528837172 and fax number 9528835395. The mailing address for Stephen C Wandersee is 8100 34th Ave S, Bloomington, Minnesota. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Stephen C Wandersee |
|---|---|
| Address | 8100 34th Ave S, Bloomington, Minnesota |
| Phone Number | 9528837172 |
| Fax Number | 9528835395 |
| Sole Proprietor | N |
| Credentials | PA |
NPI Number Detail
| NPI Number | 1407822554 |
|---|---|
| Provider Enumeration Date | 2006-02-28 |
| Last Updated Date | 2015-03-24 |
Provider Mailing Address Detail
| Address | 8100 34th Ave S |
|---|---|
| City | Bloomington |
| State | Minnesota (MN) |
| Post Code | 554251672 |
| Phone Number | 9528837172 |
| Fax Number | 9528835395 |
Provider's Primary Taxonomy Detail
| Speciality | Physician Assistant |
|---|---|
| Taxonomy | 363A00000X |
| Licence No | 8866 |
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Definition: A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perfor |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 477448500 | MN | -- |
Post Comment/ Review Below
Can you provide the Stephen C Wandersee's physical address?
The Stephen C Wandersee is physically located at 8100 34Th Ave S, in the city of Bloomington, MN, with the postal code 554251672.
What is the Stephen C Wandersee's area of specialization and corresponding taxonomy classification?
The Stephen C Wandersee's specialty field is Physician Assistant, and it falls under the taxonomy code 363A00000X, which categorizes healthcare providers based on their specialties.
On what date did the Stephen C Wandersee receive its 1407822554 assignment from the Centers for Medicare & Medicaid Services?
The Stephen C Wandersee was assigned its 1407822554 by the Centers for Medicare & Medicaid Services on 2006-02-28.
As of what date were the Stephen C Wandersee's details last updated?
The information pertaining to the Stephen C Wandersee, including its address, specialty, and other details, was most recently updated on 2015-03-24.
As of what date were the details related to Stephen C Wandersee most recently updated or revised?
The information pertaining to Stephen C Wandersee, including its address, specialty, and other relevant details, was last updated or revised on 2015-03-24.