Vanderjagt, Timothy J
Vanderjagt, Timothy J is an individual health care provider with primary practice located at 455 Saint Michaels Dr , Santa Fe NM 87505-7601. He recently has only one registered license in Allopathic & Osteopathic Physicians / Anatomic Pathology & Clinical Pathology, which is considered as his primary health care specialty. Vanderjagt, Timothy J can be contacted via phone (505) 820-5274.Contact Information
Primary practice address
455 Saint Michaels Dr
Santa Fe NM 87505-7601
Phone: (505) 820-5274
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Anatomic Pathology & Clinical Pathology | 207ZP0102X | MD2007-0397 | New Mexico |
Profile Details
| NPI number | 1780876540 |
|---|---|
| LBN Legal business name | Vanderjagt, Timothy J |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Aug 15th, 2007 |
| Last updated | May 9th, 2008 - about 18 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1780876540 | NPPES |
| New Mexico | MEDICAID | 21079021 | |
| New Mexico | Other | NM001G14 |
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