Van Fossen, Douglas

Van Fossen, Douglas is an individual health care provider with primary practice located at 260 Polaris Pkwy Fl 2 , Westerville OH 43082-8019. He recently has 3 registered licenses in different health care specialties including Other Service Providers / Specialist, Allopathic & Osteopathic Physicians / Interventional Cardiology, Allopathic & Osteopathic Physicians / Cardiovascular Disease. Allopathic & Osteopathic Physicians / Cardiovascular Disease is his primary health care specialty. Van Fossen, Douglas can be contacted via phone (614) 533-3470.

Contact Information

Primary practice address
260 Polaris Pkwy Fl 2 Westerville OH 43082-8019
Phone: (614) 533-3470
Fax: (614) 533-3160
Website:
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Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Specialist 174400000X 35046445 Ohio
Allopathic & Osteopathic Physicians / Interventional Cardiology 207RI0011X 35.046445 Ohio
Allopathic & Osteopathic Physicians / Cardiovascular Disease 207RC0000X 35.046445 Ohio

Profile Details

NPI number 1629039698
LBN Legal business name Van Fossen, Douglas
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 30th, 2006
Last updated Apr 18th, 2024 - about 5 months ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1629039698 NPPES
Ohio MEDICAID 0554967

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