Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RR0500X | Rheumatology | 0102206034 | VA |
NPI | 1053810093 |
---|---|
Provider Name | Dr. Seth Joseph Vanderveer |
First Address | Wright Patterson Afb, OH 45433-5529 |
Second Address | Wright Patterson Afb, OH 45433 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/02/2018 |
Last Update Date | 11/04/2021 |