Individual
TRENT L. VANDE GARDE
Active
Individual
TRENT L. VANDE GARDE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
04-28231
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100421700A
—
KS
01
—
101177
BCBS OF KS
KS
01
—
180042685
PALMETTO GBA
KS
Enumeration date
08/30/2006
Last updated
10/08/2013
Update your record
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