Organization
ROSEBURG HEART ASSOCIATES PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
FREDERIC J VAN DIS MD (PRESIDENT)
(541) 677-6521
Entity
Organization
Contact information
Practice address
2700 NW STEWART PKWY, SUITE 200, ROSEBURG, OR 97470-1281
(541) 677-6521
Mailing address
2700 NW STEWART PKWY, SUITE 200, ROSEBURG, OR 97470-1281
(541) 677-6521
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
MD12356
OR
Other
Enumeration date
04/24/2007
Last updated
10/30/2007
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