MARK J WANDERMAN


Address: 2535 University Ave Se, Minneapolis, MN 55414-3205
Phone: 6126722350

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).

Provider Overview

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

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 208000000X Pediatrics 30314 MN Allopathic & Osteopathic Physicians

Other Provider Identifier

State Issuer Identifier Type Code
MN 454372600 05

Office Location

Street Address 2535 UNIVERSITY AVE SE
City MINNEAPOLIS
State MN
Zip Code 55414-3205

Providers in the same location

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

Providers in the same zip code

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 Information

Taxonomy Code 208000000X
Grouping Allopathic & Osteopathic Physicians
Classification Pediatrics

Taxonomy Definition

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.

Providers in the same taxonomy and city

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

Competitor

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City MINNEAPOLIS
Zip Code 55414

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Dataset Information

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.

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