Individual
ANDREA WENDEROTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RPH
Contact information
Practice address
1000 N COLLEGE AVE, BLOOMINGTON, IN 47404-3550
(812) 339-2233
Mailing address
2668 E CIANA CT, BLOOMINGTON, IN 47401-8358
(812) 824-7732
Taxonomy
Speciality
Code
Description
License number
State
208U00000X
Clinical Pharmacology Physician
Primary
26018364A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
SHANER54
—
IN
Enumeration date
12/10/2020
Last updated
12/10/2020
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