Individual
DR. DOUGLAS VONDERFECHT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1 EDMUNDSON PL, COUNCIL BLUFFS, IA 51503-4658
(712) 396-4300
(712) 396-7069
Mailing address
PO BOX 3755, OMAHA, NE 68103-0755
(402) 354-2100
(402) 354-2155
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
17681
NE
207R00000X
Internal Medicine Physician
Primary
23836
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1740391127
—
IA
05
—
47068731712
—
NE
Enumeration date
08/31/2006
Last updated
12/17/2013
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