Individual
LOREN MILLARD VANDEUSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3636 BROADWAY, GROVE CITY, OH 43123-2202
(614) 871-3234
(614) 871-1494
Mailing address
3636 BROADWAY, GROVE CITY, OH 43123-2202
(614) 871-3234
(614) 871-1494
Taxonomy
Speciality
Code
Description
License number
State
207QA0505X
Adult Medicine Physician
Primary
51677
OH
Other
Enumeration date
09/14/2006
Last updated
07/08/2007
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