Vande Waa, John A.

Vande Waa, John A. is an individual health care provider with primary practice located at 2451 Fillingim St Mastin Bldg, Mobile AL 36617-2238. He recently has only one registered license in Allopathic & Osteopathic Physicians / Infectious Disease, which is considered as his primary health care specialty. Vande Waa, John A. can be contacted via phone (251) 470-5890.

Contact Information

Primary practice address
2451 Fillingim St Mastin Bldg Mobile AL 36617-2238
Phone: (251) 470-5890
Fax: (251) 471-7925
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Infectious Disease 207RI0200X DO-401 Alabama

Profile Details

NPI number 1447290630
LBN Legal business name Vande Waa, John A.
Credentials DO, PHD
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 7th, 2006
Last updated May 12th, 2015 - about 11 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1447290630 NPPES
Mississippi MEDICAID 00121697
Mississippi MEDICAID 009935162
Mississippi MEDICAID 255961700
Mississippi Other 92-10077
Mississippi Other 51505303
Mississippi Other 51532424
Mississippi MEDICAID 000023305
Mississippi MEDICAID 009975140
Mississippi MEDICAID 1503762
Mississippi Other 51023305
Mississippi Other 51543343

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