Individual
MICHAEL J VADOVSKY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
2900 DOOLITTLE DR, ELLSWORTH AFB, SD 57706
(605) 385-3788
Mailing address
2900 DOOLITTLE DR, ELLSWORTH AFB, SD 57706-4821
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
10/13/2017
Last updated
02/05/2019
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