Individual
PHILIP H VANDERSTOEP
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1990 CONNECTICUT AVE S, SARTELL, MN 56377-2554
(320) 257-5595
(320) 257-5596
Mailing address
PO BOX 7366, SAINT CLOUD, MN 56302-7366
(320) 257-5595
(320) 257-5596
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
22588
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
104072300
—
MN
01
—
106088C561
UCARE OF MINNESOTA
MN
01
—
16-29701
MEDICA
MN
01
—
26650
ARAZ/ AMERICA'S PPO
MN
01
—
300039116
RAILROAD MEDICARE
MN
01
—
411772562
GREATWEST HEALTHCARE
MN
01
—
54886VA
BLUE CROSS BLUE SHIELD
MN
01
—
965251008761
PREFERRED ONE
MN
01
—
HP25529
HEALTH PARTNERS
MN
Enumeration date
07/28/2005
Last updated
08/12/2011
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