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Individual

DANIEL T VANDENBOSCH

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
2375 EDGEWOOD RD SW, CEDAR RAPIDS, IA 52404-4736
(319) 396-1983
(319) 396-3183
Mailing address
2230 WILEY BLVD SW, CEDAR RAPIDS, IA 52404-2364
(319) 396-1983
(319) 396-3183

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
29364
IA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
6085159
IA
05
7085159
IA
01
930029628
RR MEDICARE
IA
Enumeration date
01/03/2006
Last updated
11/21/2012
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