Individual
DR. DOUGLAS VAN FOSSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
260 POLARIS PKWY FL 2, WESTERVILLE, OH 43082-8019
(614) 533-3470
(614) 533-3160
Mailing address
PO BOX 7527, DUBLIN, OH 43017-0727
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
35046445
OH
207RC0000X
Cardiovascular Disease Physician
Primary
35.046445
OH
207RI0011X
Interventional Cardiology Physician
35.046445
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0554967
—
OH
Enumeration date
03/30/2006
Last updated
04/18/2024
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