Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Dr. David Bryan Waggonner, MD

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1164600342

Dr. David Bryan Waggonner, MD is an Obstetrics/Gynecology in Saint Louis Park, Minnesota. Graduated from Loma Linda University School of Medicine in 2006, 20 years ago. Practices with Park Nicollet Clinic, a 1,773-clinician group and accepts Medicare assignment. Licensed in Minnesota.

Years since qualifying
20
Trained at
Loma Linda University School of Medicine
Licensed in
MN
In the registry since
2008
Specialties on file
2
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

6500 Excelsior Blvd
Saint Louis Park, MN 55426-4702
Phone: (952) 993-3282
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Urogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician (primary) Taxonomy 207VF0040X · Licence 56763 (MN)
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X

Record details

NPI number1164600342
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedFebruary 10, 2008
Last updated in NPPESDecember 28, 2022
Certification dateDecember 28, 2022
Mailing address8170 33rd Ave S # Ms 21110q, Minneapolis, MN 55425-4516

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyOBSTETRICS/GYNECOLOGY
Medical schoolLOMA LINDA UNIVERSITY SCHOOL OF MEDICINE
Graduated 2006 (20 years in practice)
Group practice Park Nicollet Clinic — 1773 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations3 on file with Medicare

Other providers in Saint Louis Park