Provider Demographics
NPI:1588005789
Name:WAAGE, TRENT GEOFFREY (MD)
Entity Type:Individual
Prefix:
First Name:TRENT
Middle Name:GEOFFREY
Last Name:WAAGE
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:501 N COLUMBIA RD STOP 9037
Mailing Address - Street 2:UNIVERSITY OF NORTH DAKOTA SURGERY, SMHS RM 5107
Mailing Address - City:GRAND FORKS
Mailing Address - State:ND
Mailing Address - Zip Code:58202-9037
Mailing Address - Country:US
Mailing Address - Phone:701-777-3067
Mailing Address - Fax:
Practice Address - Street 1:501 N COLUMBIA RD STOP 9037
Practice Address - Street 2:UNIVERSITY OF NORTH DAKOTA SURGERY, SMHS RM 5107
Practice Address - City:GRAND FORKS
Practice Address - State:ND
Practice Address - Zip Code:58202-9037
Practice Address - Country:US
Practice Address - Phone:701-777-3067
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-07-16
Last Update Date:2013-07-16
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NDRL 12884208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery