Mark J Wanderman
MD | Pediatrics | Male
Mark J Wanderman, MD is a Minneapolis, Minnesota based Pediatric doctor with medical specialization in
General Pediatrics.
Current practice location of Mark J Wanderman is
2535 University Ave Se, Minneapolis, Minnesota - 55414-3205. He can be contacted on phone at
612-672-2350 and fax number 651-642-9441.
Mark J Wanderman is a sole proprietor of his business.
NPI number (Unique professional ID) for Mark J Wanderman is
1285660837 which was assigned by NPPES on 24 Jun, 2006 and it was last updated on 11 Apr, 2012.
Mark J Wanderman license number is
30314 for Pediatrics (208000000X) in Minnesota.
Mark J Wanderman is a pediatrician who is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.
Complete Profile:
Mark J Wanderman basic information including his official name, gender, specialization, credentials etc. are as mentioned below.
| Specialization : | Pediatrics |
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| Provider Name : | Mark J Wanderman |
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| Credential : | MD |
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| Gender : | Male |
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Business Address:
Mark J Wanderman address, contact phone number and fax are as below. Patients can directly walkin to the clinic or can call on the below given phone number for appointment.
| Primary Address : | 2535 University Ave Se
Minneapolis, MN, 55414-3205
United States |
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| Phone Number : | 612-672-2350 |
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| Fax Number : | 651-642-9441 |
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Professional Identification Codes:
NPI number stands for National Provider Identifier which is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). NPI details are as mentioned below.
| NPI Number : | 1285660837 |
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| NPI Entity Type : | Individual |
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| First Enrolment Date : | 24 Jun, 2006 |
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| Last Updated On : | 11 Apr, 2012 |
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Licenses and Specialities:
Physicians/Organizations can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for Mark J Wanderman are as mentioned. Primary taxonomy code for Mark J Wanderman, MD is
208000000X (Pediatrics).
| Taxonomy Code | Speciality | Primary | License No. | State |
|---|
| 208000000X | Pediatrics | Yes | 30314 | MN |
Legacy Identifiers:
Other legacy medical identifiers of Mark J Wanderman such as Medicaid, Medicare PIN, NSC, UPIN etc. are mentioned below.
| Identifier | Identifier Type | State | Issuer |
|---|
| 454372600 | MEDICAID | MN | |
Mailing Address:
Mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned business address only.
| Mailing Address : | 2535 University Ave Se
Minneapolis, MN, 55414-3205
United States |
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| Phone Number : | 612-672-2350 |
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| Fax Number : | 651-642-9441 |
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Business Location:
Patients can refer following map for directions to
Mark J Wanderman practice address. Don't forget to take prior appointment before visiting.
** Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES.