Individual
DR. RICHARD JASON VONDERHAAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
11725 ILLINOIS ST STE 355, CARMEL, IN 46032-3009
(317) 688-2790
Mailing address
250 N SHADELAND AVE, INDIANAPOLIS, IN 46219-4959
Taxonomy
Speciality
Code
Description
License number
State
208200000X
Plastic Surgery Physician
Primary
01082624A
IN
208600000X
Surgery Physician
01082624A
IN
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/12/2011
Last updated
02/02/2021
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