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Individual

DR. MARK VANDENBOSCH

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
1330 S VALLEY VIEW BLVD, LAS VEGAS, NV 89102-1865
(702) 675-4600
Mailing address
2844 EVENING ROCK ST, LAS VEGAS, NV 89135-1631
(321) 698-6853
(702) 818-3452

Taxonomy

Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
14668
NV
207L00000X
Anesthesiology Physician
ME64003
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
374010200
FL
Enumeration date
10/02/2006
Last updated
09/17/2021
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