Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207R00000X | Internist | 53222 | MN |
Y | 111NI0900X | Internist | 53222 | MN |
N | 207RG0300X | Geriatric Medicine | 106836 | MN |
N | 207RG0300X | Geriatric Medicine | 53222 | MN |
NPI | 1154550200 |
---|---|
Provider Name | Brandon P Verdoorn |
First Address | Rochester, MN 55905-0001 |
Second Address | Rochester, MN 55905-0001 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/07/2009 |
Last Update Date | 21/08/2020 |