MR. ROBERT FRED VANDEBORNE NPI 1053864835

NPI Information

  • NPI: 1053864835
  • Provider Name: MR. ROBERT FRED VANDEBORNE
  • Classification: Radiologic Technologist - 247100000X
  • Entity Type: Individual
  • Address: 12647 OLIVE BLVD
    SUITE 600
    SAINT LOUIS, MO
    ZIP 63141
  • Phone: (800) 325-3982

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NPI Details

MR. Robert Fred Vandeborne is a radiologic technologist in Saint Louis, MO. The provider is a medical imaging or radiation therapy professional who is appropriately educated and trained to perform medical imaging procedures using ionizing and nonionizing radiation. MR. Robert Fred Vandeborne NPI is 1053864835. 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:

12647 OLIVE BLVD
SUITE 600
SAINT LOUIS, MO
ZIP 63141-393
Phone: (800) 325-3982
Fax: (877) 685-9880

The enumeration date for this NPI number is 7/28/2016 and was last updated on 7/28/2016.

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
1247100000XRadiologic TechnologistYes

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: 11/21/2025

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