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Individual

WANDA P. ADEFRIS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
1875 WOODWINDS DR, SUITE 110, WOODBURY, MN 55125-2298
(651) 686-6400
(651) 714-1264
Mailing address
215 RADIO DRIVE, SUITE 200, WOODBURY, MN 55125-2298
(651) 686-6400
(651) 714-1264

Taxonomy

Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
37274
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0702346
MEDICA
01
1006635
PREF ONE
01
101391
HEALTH PARTNERS
01
36P25AD
BCBS
05
828818600
MN
Enumeration date
12/19/2005
Last updated
05/15/2020
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