Individual
NICHOLAS ROBERT VANMALDEREN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
5400 BOURBON ST, COLUMBUS, OH 43221-5564
(740) 707-3761
Mailing address
5400 BOURBON ST, COLUMBUS, OH 43221-5564
(740) 707-3761
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
34.009948
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3085576
—
OH
Enumeration date
07/24/2007
Last updated
03/25/2011
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