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NPI Code Detail

MEDICARE: KEVIN SCOTT VANDER WERFF JR. DO

MEDICARE: KEVIN SCOTT VANDER WERFF JR. DO
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1390200000XStudent in an Organized Health Care Education/Training Program

General Provider Information

NPI Number : 1891633319
Entity Type Code : Individual
Provider Name (Legal Business Name) : KEVIN SCOTT VANDER WERFF JR. DO
Provider Business Mailing Address
First Line : 3000 ARLINGTON AVE
Second Line :
City : TOLEDO
State : OH
Zip : 43614-2595
Country : US
Telephone Number : 419-383-6462
Fax Number :
Provider Business Practice Location Address
First Line : 3000 ARLINGTON AVE
Second Line :
City : TOLEDO
State : OH
Zip : 43614-2595
Country : US
Telephone Number : 419-383-6462
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/24/2026
Last Update Date : 03/24/2026

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