Individual
MR. THEOPHILUS NARH ADDOTTE-WAYO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
7506 DERBY LN, SHAKOPEE, MN 55379-7090
(651) 420-0499
Mailing address
7506 DERBY LN, SHAKOPEE, MN 55379-7090
(651) 420-0499
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
—
MN
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
MN
Other
Enumeration date
05/27/2026
Last updated
05/27/2026
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