Individual
LAURIE MARIE VAN DONSELAAR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
6911 E US HIGHWAY 36, AVON, IN 46123-8926
(317) 272-8033
(317) 272-8044
Mailing address
1100 SOUTHFIELD DR STE 1370, PLAINFIELD, IN 46168-4300
(317) 837-5566
(317) 837-5580
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
02004178A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201096470
—
IN
Enumeration date
04/14/2009
Last updated
03/17/2021
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