Individual
JOHN A. VANDE WAA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO, PHD
Taxonomy
Speciality
Code
Description
License number
State
207RI0200X
Infectious Disease Physician
Primary
DO-401
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000023305
—
AL
05
—
00121697
—
MS
05
—
009935162
—
AL
05
—
009975140
—
AL
05
—
1503762
—
FL
05
—
255961700
—
FL
01
—
51023305
BCBS
AL
01
—
51505303
BCBS
AL
01
—
51532424
BCBS
AL
01
—
51543343
BCBS - FILLINGIM ST
AL
01
—
92-10077
UNITED HEALTHCARE
AL
Enumeration date
06/07/2006
Last updated
05/12/2015
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