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Individual

ROBERT H. VANDERBERG

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
2600 GREENWOOD RD, SHREVEPORT, LA 71103-3908
(318) 212-4000
(706) 596-6704
Mailing address
PO BOX 3488, TUPELO, MS 38803-3488
(866) 264-3435
(706) 596-6704

Taxonomy

Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
3022839
LA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
2442759
LA
Enumeration date
04/03/2017
Last updated
06/24/2024
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