Individual
TODD MARTIN VANWYNGARDEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.P.M.
Contact information
Practice address
8901 W 74TH ST, SUITE 200, SHAWNEE MISSION, KS 66204-2204
(913) 432-5052
(913) 432-9990
Mailing address
8901 W 74TH ST, SUITE 200, SHAWNEE MISSION, KS 66204-2204
(913) 432-5052
(913) 432-9990
Taxonomy
Speciality
Code
Description
License number
State
213ES0131X
Foot Surgery Podiatrist
Primary
00245
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
308097104
—
MO
01
—
480019065
MEDICARE RAILROAD
KS
Enumeration date
02/02/2006
Last updated
02/11/2013
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