MARK J WANDERMAN (NPI# 1285660837) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1285660837 |
| Entity Type | Individual |
| Full Name | MARK J WANDERMAN |
| Credential | MD |
| Practice Address |
2535 University Ave Se Minneapolis MN 55414-3205 |
| Practice Telephone | 6126722350 |
| Practice Fax Number | 6516429441 |
| Mailing Telephone | 6126722350 |
| Mailing Fax Number | 6516429441 |
| Enumeration Date | 2006-06-24 |
| Last Update Date | 2012-04-11 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208000000X | Pediatrics | 30314 | MN | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MN | 454372600 | 05 |
| Street Address |
2535 UNIVERSITY AVE SE |
| City | MINNEAPOLIS |
| State | MN |
| Zip Code | 55414-3205 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306813217 | Pamela M Heggie | Pediatrics | 2535 University Ave Se, Minneapolis, MN 55414-3205 | 2006-03-01 |
| 1700415692 | Ethan Jacob Nemmers | Student in an Organized Health Care Education/Training Program | 2535 University Ave Se, Minneapolis, MN 55414-3205 | 2020-04-03 |
| 1770937781 | Tanya Lynn Velishek | Nurse Practitioner | 2535 University Ave Se, Minneapolis, MN 55414-3205 | 2016-04-15 |
| 1851570956 | Kathleen Averill | Nurse Practitioner | 2535 University Ave Se, Minneapolis, MN 55414-3205 | 2007-10-25 |
| 1245422021 | Fairview Clinics | Clinic/Center | 2535 University Ave Se, Minneapolis, MN 55414-3205 | 2007-08-15 |
| 1982752614 | Janelle M Dailey | Pediatrics | 2535 University Ave Se, Minneapolis, MN 55414-3205 | 2007-01-08 |
| 1043380926 | Emily Cray Borman-shoap | Pediatrics | 2535 University Ave Se, Minneapolis, MN 55414-3205 | 2006-11-08 |
| 1295840783 | Nancy Lorene Ott | Allergy & Immunology | 2535 University Ave Se, Minneapolis, MN 55414-3205 | 2006-08-21 |
| 1518934280 | Carolyn J Mckay | Pediatrics | 2535 University Ave Se, Minneapolis, MN 55414-3205 | 2006-03-02 |
| 1831166743 | Karl H Chun | Pediatrics | 2535 University Ave Se, Minneapolis, MN 55414-3205 | 2006-03-01 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407496516 | Liza N Meredith | Psychologist | Acacia Counseling and Wellness, 2724 University Ave Se Unit B, Minneapolis, MN 55414 | 2020-01-07 |
| 1346888732 | Danielle Lee Ann Vogler-bos | Naturopath | 575 Se 9th St, Suite #52, Minneapolis, MN 55414 | 2019-12-16 |
| 1164071148 | Amy C Moran | Psychologist | Acacia Counseling & Wellness, 2724 University Ave., Unit B, Minneapolis, MN 55414 | 2019-09-11 |
| 1346806585 | Kristen Bastug | Student in an Organized Health Care Education/Training Program | General Pediatrics and Adolescent Health, 1932k, 1717 Delaware Street Southeast, Suite 353, Minneapolis, MN 55414 | 2019-05-14 |
| 1053881698 | Lauren Michelle Scholder | Psychologist | 401 Main St Se Apt 7009, Minneapolis, MN 55414 | 2018-11-27 |
| 1427530666 | Kelli Howard | Psychologist | 2724 University Ave Se Unit B, Minneapolis, MN 55414 | 2018-09-04 |
| 1306370218 | Jiexiong Yang | Student in an Organized Health Care Education/Training Program | 814 Essex St Se, Minneapolis, MN 55414 | 2017-04-18 |
| 1598297699 | Patrick Curran | Student in an Organized Health Care Education/Training Program | 628 University Ave Se, Apt. 112, Minneapolis, MN 55414 | 2017-03-29 |
| 1679923957 | Jillian Theresa Tholen | Dietitian, Registered | 411 E Hennepin Ave, Minneapolis, MN 55414 | 2016-06-16 |
| 1073960290 | First Language Interpreter & Translation Services LLC | Interpreter | 2828 University Ave Se Suite 150, Minneapolis, MN 55414 | 2016-05-17 |
| Find all providers in zip 55414 | ||||
| Taxonomy Code | 208000000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| A pediatrician 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. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certificatio - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356998215 | Katie Marie Heille | Pediatrics | 305 W Franklin Ave Apt 201, Minneapolis, MN 55404-2308 | 2019-08-24 |
| 1942736103 | Taylor Ashley Argo | Pediatrics | 717 Delaware Street Se, Suite 353, General Pediatrics & Adolescent Health, Minneapolis, MN 55455 | 2017-05-10 |
| 1932634052 | Christopher Maierhofer | Pediatrics | 715 S 8th St Fl 3, Minneapolis, MN 55404-1210 | 2017-04-26 |
| 1265894463 | Adam David Langenfeld | Pediatrics | 717 Delaware St Se Fl 3, Minneapolis, MN 55414 | 2016-03-26 |
| 1568858132 | Joseph Resch | Pediatrics | 2450 Riverside Ave, 5th Floor East Building, 8951g (campus Delivery Code), Minneapolis, MN 55454-1450 | 2015-04-10 |
| 1295120020 | Lauren Michelle Yauch | Pediatrics | 2512 S 7th St Fl 3, Minneapolis, MN 55454-1404 | 2015-03-30 |
| 1669870374 | Mary Lois Hall | Pediatrics | 3500 Humboldt Ave S, Minneapolis, MN 55408-3316 | 2014-12-11 |
| 1821433731 | Megan Van Ee Hilgers | Pediatrics | 2530 Chicago Ave Ste 175, Minneapolis, MN 55404-4289 | 2013-05-06 |
| 1811332844 | Chase Walter Shutak | Pediatrics | 2530 Chicago Ave Ste 309, Minneapolis, MN 55404-4289 | 2013-05-03 |
| 1619222197 | Abdul Kadir Abdi | Pediatrics | 2525 Chicago Ave Ste 390, Minneapolis, MN 55404-4518 | 2012-07-19 |
| Find all providers in MINNEAPOLIS | ||||
| City | MINNEAPOLIS |
| Zip Code | 55414 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.