Individual
KRISTOFER A VANDER ZWAAG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
22815
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00059
BLUE CROSS BLUE SHIELD
NE
01
—
106553
BLUE CROSS BLUE SHIELD
KS
01
—
251187
MIDLANDS CHOICE
NE
01
—
68901B014
TRICARE/TRIWEST
NE
01
—
P00410877
RAILROAD MEDICARE
—
Enumeration date
05/22/2006
Last updated
03/07/2023
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