Individual
DR. MARK THOMAS VANDENBERG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1215 DUFF AVE, AMES, IA 50010-3014
(515) 239-4725
(515) 956-4130
Mailing address
1215 DUFF AVE, AMES, IA 50010-3014
(515) 239-4725
(515) 956-4130
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
25285
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0202259
—
IA
Enumeration date
11/15/2005
Last updated
09/07/2023
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