Individual
FREDERIC E. VANBASTELAER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
371 DUKE DR, RICHMOND, IN 47374-4598
(765) 969-1181
Mailing address
371 DUKE DR, RICHMOND, IN 47374-4598
(765) 969-1181
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
01037766
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100319780
—
IN
Enumeration date
04/26/2006
Last updated
07/12/2022
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