Individual
PAULA A VANDERFORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
MD28634
OR
2080H0002X
Pediatric Hospice and Palliative Medicine Physician
2022038337
MO
2080H0002X
Pediatric Hospice and Palliative Medicine Physician
Primary
MD28634
OR
2080P0203X
Pediatric Critical Care Medicine Physician
MD28634
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
028523
DMAP
OR
01
—
R144108
MEDICARE PTAN
OR
Enumeration date
08/24/2005
Last updated
10/17/2024
Update your record
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