Individual
DR. KEVIN R VANDERVEEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1375 E 19TH AVE, DENVER, CO 80218-1114
(303) 338-4545
Mailing address
10350 E DAKOTA AVE, DENVER, CO 80247-1314
(303) 338-4545
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
47483
CO
207P00000X
Emergency Medicine Physician
A77861
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A778610
—
CA
01
—
020129
KAISER COMMERCIAL NUMBER
CO
05
—
56486731
—
CO
Enumeration date
11/01/2006
Last updated
08/08/2022
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