Provider Demographics
NPI:1467477471
Name:VAN DELDEN, JAMES BEREND (MD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:BEREND
Last Name:VAN DELDEN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:902 NEBRASKA ST
Mailing Address - Street 2:
Mailing Address - City:WAYNE
Mailing Address - State:NE
Mailing Address - Zip Code:68787-1428
Mailing Address - Country:US
Mailing Address - Phone:402-833-5531
Mailing Address - Fax:
Practice Address - Street 1:100 INDIAN HILLS DRIVE
Practice Address - Street 2:
Practice Address - City:MACY
Practice Address - State:NE
Practice Address - Zip Code:68039-0250
Practice Address - Country:US
Practice Address - Phone:402-837-5381
Practice Address - Fax:402-837-5303
Is Sole Proprietor?:No
Enumeration Date:2006-07-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE16596208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice