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Individual

PETER E VONDERAU

Active
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Individual

PETER E VONDERAU

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Taxonomy

Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
0101277437
VA
208100000X
Physical Medicine & Rehabilitation Physician
7446
SD
208VP0014X
Interventional Pain Medicine Physician
7446
SD

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1174500821
TLC ADVANTAGE, L.L.C.
SD
05
1174500821
SD
01
23-00706
MEDICA
SD
Enumeration date
12/23/2005
Last updated
07/11/2023
Update your record

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