Individual
ANDREW D RENDOFF
Active
Individual
ANDREW D RENDOFF
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
P.A.
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
9077
AZ
363A00000X
Physician Assistant
T01462
KS
363AS0400X
Surgical Physician Assistant
2017012741
MO
363AS0400X
Surgical Physician Assistant
Primary
9077
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200442050A
—
KS
01
—
427175
MEDICARE NUMBER
KS
Enumeration date
08/10/2007
Last updated
09/08/2022
Update your record
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