National Provider Identifier Database

FREDERIC J VAN DIS, MD – NPI #1093786261
Cardiovascular Disease

An internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms.


Contact Information

FREDERIC J VAN DIS, MD
2801 NW MERCY DR
STE. 300
ROSEBURG, OR97471
Phone: 541-677-1555
Fax: 541-677-6543
Website:
Specialty Taxonomy Code
* Cardiovascular Disease 207RC0000X

* Indicates primary specialty

NPI Profile & details for FREDERIC J VAN DIS

NPI Number 1093786261
Credentials MD
Entity Individual
Enumeration date 01/27/2006
Last updated 05/26/2020 - About 6 years ago
Sole proprietor1 No
Identifiers
  • OR License #: MD12356
  • OR Medicaid: 114173
  • OR Other: MD12356 LICENSE
  • OR Other: 060070869 RAILROAD MEDICARE
Hospital affiliation n/a

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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