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Individual
CYNTHIA L. VANDERBOSCH
Active
Individual
CYNTHIA L. VANDERBOSCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
01037767A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000000312
MPLAN
—
01
—
000000091894
BLUE CROSS BLUE SHIELD
—
01
—
080122015
RAILROAD MEDICARE
IN
05
—
100369350
—
IN
01
—
1975
PHYSICIANS HEALTH PLAN
—
Enumeration date
11/04/2005
Last updated
03/04/2013
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