Individual
KEVIN MARINUS VANDEN BERGE
Active
Individual
KEVIN MARINUS VANDEN BERGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
N2329
TX
390200000X
Student in an Organized Health Care Education/Training Program
AP 2247799-54061
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
281982301
—
TX
01
—
8CU164
BLUE CROSS
—
Enumeration date
05/08/2007
Last updated
03/29/2019
Update your record
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