Brydon Thomas Wanner, is a
Specialist based in Moorhead, Minnesota. Brydon Thomas Wanner is licensed to practice in * (Not Available) (license number ) and his current practice location is
1505 30th Ave S, Moorhead, Minnesota. He can be reached at his office (for appointments etc.) via phone at
(218) 287-4338.
NPI number for Brydon Thomas Wanner is 1275267932 and his current mailing address is 1547 30th Ave S, Moorhead, Minnesota. He
does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1275267932.
Healthcare Provider's Profile
| Full Name | Brydon Thomas Wanner |
|---|
| Gender | Male |
|---|
| Speciality | Specialist |
|---|
| Location | 1505 30th Ave S, Moorhead, Minnesota |
|---|
| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
|---|
NPI Data:
- NPI Number: 1275267932
- Provider Enumeration Date: 07/10/2022
- Last Update Date: 09/12/2024
Medical Identifiers
Medical identifiers for Brydon Thomas Wanner such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1275267932 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 106H00000X | Marriage & Family Therapist | (* (Not Available)) | Secondary |
| 225C00000X | Rehabilitation Counselor | (* (Not Available)) | Secondary |
| 390200000X | Student In An Organized Health Care Education/training Program | (* (Not Available)) | Secondary |
| 174400000X | Specialist | (* (Not Available)) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Brydon Thomas Wanner is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Brydon Thomas Wanner,
1547 30th Ave S,
Moorhead, MN 56560-5149
Ph: (218) 287-4338 | Brydon Thomas Wanner,
1505 30th Ave S,
Moorhead, MN 56560-5149
Ph: (218) 287-4338 |
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