DR. DAVID THEODORE VANDERMOLEN M.D. NPI 1366462368

NPI Information

NPI: 1366462368
Provider Name: DR. DAVID THEODORE VANDERMOLEN, M.D.
Classification: Obstetrics & Gynecology - 207VE0102X
Entity Type: Individual

Specialization: Reproductive Endocrinology

PECOS Registration: Yes

Address:
2401 GREENWOOD RD
SUITE A
SHREVEPORT, LA
ZIP 71103
Phone: (318) 841-5800
Get Directions

DR. David Theodore Vandermolen, M.D. is a reproductive endocrinology obstetrics gynecology in Shreveport, LA. The provider is an obstetrician/gynecologist who is capable of managing complex problems relating to reproductive endocrinology and infertility. DR. David Theodore Vandermolen, M.D. NPI is 1366462368. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

2401 GREENWOOD RD
SUITE A
SHREVEPORT, LA
ZIP 71103-010
Phone: (318) 841-5800
Fax: (318) 841-5817

The NPI 1366462368 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 7/20/2006 and was last updated on 4/8/2020.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	207VE0102X	Obstetrics & Gynecology	Reproductive Endocrinology	12977R	LOUISIANA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	1551767	MEDICAID	LOUISIANA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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