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General NPI Number Information
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NPI Number | 1790890879
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Entity Type | Individual
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Provider Name | THOMAS WALTER VONDOHLEN M.D.
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Gender | Male
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Dates
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Enumeration Date | 08/20/2006
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Last Update Date | 09/18/2025
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Provider Practice Location Address
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Address Line | 208 E MEADOW LN
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City | CALDWELL
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State | WV
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Zip | 24925-7139
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Country | US
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Telephone | 304-647-2030
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Fax | 304-647-2033
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Provider Business Mailing Address
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Address Line | 157 SKYLAR DR
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City | LEWISBURG
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State | WV
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Zip | 24901-9359
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Country | US
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Telephone | 304-647-2030
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Fax | 304-647-2033
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | 13305
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License Number State | WV
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