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Individual

DR. AUSTIN MAURICE VANDEBERG

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
6071 E WOODMEN RD STE 105, COLORADO SPRINGS, CO 80923-2610
(719) 597-8704
Mailing address
PO BOX 35380, LAS VEGAS, NV 89133-5380
(702) 579-3203

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
7589
NE
208000000X
Pediatrics Physician
Primary
DR.0060771
CO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
9000164655
CO
Enumeration date
06/29/2015
Last updated
04/16/2026
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