Provider Demographics
NPI:1891033973
Name:VANDAS, ANDREW CHRISTIAN (PA-C)
Entity Type:Individual
Prefix:
First Name:ANDREW
Middle Name:CHRISTIAN
Last Name:VANDAS
Suffix:
Gender:M
Credentials:PA-C
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Other - First Name:
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Mailing Address - Street 1:4350 S NATIONAL AVE
Mailing Address - Street 2:SUITE C200
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MO
Mailing Address - Zip Code:65810-2607
Mailing Address - Country:US
Mailing Address - Phone:417-447-1000
Mailing Address - Fax:417-447-6150
Practice Address - Street 1:4350 S NATIONAL AVE
Practice Address - Street 2:SUITE C200
Practice Address - City:SPRINGFIELD
Practice Address - State:MO
Practice Address - Zip Code:65810-2607
Practice Address - Country:US
Practice Address - Phone:417-447-1000
Practice Address - Fax:417-447-6150
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-23
Last Update Date:2013-01-23
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MO363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical