Individual
DR. DOUGLAS J VANDAELE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
200 HAWKINS DR, IOWA CITY, IA 52242-1009
(319) 353-8162
(319) 356-4547
Mailing address
200 HAWKINS DR, IOWA CITY, IA 52242-1009
(319) 353-8162
(319) 356-4547
Taxonomy
Speciality
Code
Description
License number
State
207YX0905X
Otolaryngology/Facial Plastic Surgery Physician
Primary
32034
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
34737
WELLMARK BCBS
IA
05
—
5169375
—
IA
Enumeration date
09/08/2005
Last updated
12/19/2007
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