Gregg D Vanderwaerdt, PA-C
Physician Assistant in Rochester, MN. Individual provider (NPI-1).
NPI number1477523769
StatusActive
Last updated in NPPESSep 8, 2020
Details
- NPI
- 1477523769
- Entity type
- Individual (NPI-1)
- Name
- Gregg D Vanderwaerdt
- Credential
- PA-C
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Jan 26, 2006
- Certification date
- Sep 8, 2020
- Last updated
- Sep 8, 2020
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363A00000X | Physician Assistant | 9762 | MN | Yes |
Practice location
200 1st St SwRochester, MN 55905-0001
Phone 507-284-2511
Mailing address
200 1st St SwRochester, MN 55905-0001
Phone 507-284-2511
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