Student in an Organized Health Care Education/Training Program
Mr. THEOPHILUS ADDOTTE-WAYO
Identity confirmed via CMS NPPES · September 30, 2026 · A directory match is not a coverage approval.
Is this your practice? This listing was imported from public provider identity data (CMS NPPES) and has not yet been claimed. Claim this listing to confirm the practice details. Plan acceptance stays unpublished until the practice reports it.
Public record
NPI 1922939149 · enumerated 2026-05-27 · record updated 2026-05-27. Source: CMS NPPES. A listing is not a TRICARE network approval.
NPPES recordGoogle Maps Apple Maps OpenStreetMap
Addresses and phones
- Mailing address 7506 DERBY LN, SHAKOPEE, MN, 55379-7090 (651) 420-0499 Google Maps Apple Maps OpenStreetMap
- Practice location 7506 DERBY LN, SHAKOPEE, MN, 55379-7090 (651) 420-0499 Google Maps Apple Maps OpenStreetMap
Specialties
- Student in an Organized Health Care Education/Training Program 390200000X · Primary
- Physician Assistant 363A00000X
In this directory
MN Scott County Shakopee Student in an Organized Health Care Education/Training Program
Locations and evidence
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Practice location
SHAKOPEE, MN, 553797090
Accepting new patientsNot reportedCMS NPPES · September 30, 2026
Plan acceptance
- No published plan acceptance yet. Confirm directly with the practice, or claim this listing if it's yours.