Individual
DR. ROGER J VANORSDOLL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3100 WINDSOR CT, ELKHART, IN 46514-5556
(574) 206-8800
(574) 206-8806
Mailing address
53793 CRYSTAL CREEK LN, ELKHART, IN 46514-3053
(574) 264-3309
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
01030025A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01030025A
MEDICAL LICENCING BOARD
IN
Enumeration date
12/14/2006
Last updated
07/08/2007
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