Waldo, Bryan
Waldo, Bryan is an individual health care provider with primary practice located at 2711 Leonard Dr Ste 101 , Valparaiso IN 46383-7121. He recently has only one registered license in Allopathic & Osteopathic Physicians / Nephrology, which is considered as his primary health care specialty. Waldo, Bryan can be contacted via phone (219) 462-6001.Contact Information
Primary practice address
2711 Leonard Dr Ste 101
Valparaiso IN 46383-7121
Phone: (219) 462-6001
Fax: (219) 464-6060
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Nephrology | 207RN0300X | 01064566A | Indiana |
Profile Details
| NPI number | 1982716486 |
|---|---|
| LBN Legal business name | Waldo, Bryan |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Aug 31st, 2006 |
| Last updated | Jun 1st, 2022 - about 2 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1982716486 | NPPES |
| Indiana | MEDICAID | 200889490 |
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