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Individual

DR. LARS E. VANDERBUR

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
9202 WEST DODGE ROAD, SUITE 101, OMAHA, NE 68114
(402) 955-7500
(402) 955-7524
Mailing address
8401 WEST DODGE ROAD, SUITE 280, OMAHA, NE 68114
(402) 955-6877
(402) 955-6880

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
22271
NE

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
239080
MIDLANDS CHOICE
NE
01
2606
BCBS
NE
05
47068937213
NE
05
565671
IA
Enumeration date
10/02/2006
Last updated
04/03/2013
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