Individual
MICHAEL D VAD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
76740
MN
367500000X
Certified Registered Nurse Anesthetist
R-158100-7
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
097N8VA
BLUE CROSS BLUE SHIELD
MN
05
—
929483000
—
MN
Enumeration date
09/27/2006
Last updated
04/18/2019
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