| Charles Jay Vandenberg Iv, DO | |
|
1293 E Parkdale Ave, Manistee, MI 49660-8904 | |
| (231) 398-1840 | |
| Not Available |
| Full Name | Charles Jay Vandenberg Iv |
|---|---|
| Gender | Male |
| Speciality | Internal Medicine |
| Experience | 14 Years |
| Location | 1293 E Parkdale Ave, Manistee, Michigan |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1750638516 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 2012020880 (Missouri) | Secondary |
| 207R00000X | Internal Medicine | 5101021764 (Michigan) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Munson Home Care | Traverse city, MI | Home health agency |
| Northern Home Care | Hart, MI | Home health agency |
| Advisacare Solutions Of Northern Michigan | Charlevoix, MI | Home health agency |
| Munson Healthcare Manistee Hospital | Manistee, MI | Hospital |
| Munson Healthcare Cadillac Hospital | Cadillac, MI | Hospital |
| Spectrum Health Ludington Hospital | Ludington, MI | Hospital |
| Paul Oliver Memorial Hospital | Frankfort, MI | Hospital |
| Munson Medical Center | Traverse city, MI | Hospital |
| Manistee County Medical Care Facility | Manistee, MI | Nursing home |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Munson Healthcare Manistee Hospital | 3072414333 | 27 |
| Entity Name | Munson Medical Center |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1083761860 PECOS PAC ID: 3072426287 Enrollment ID: O20040108000904 |
| Entity Name | Munson Healthcare Manistee Hospital |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1649457771 PECOS PAC ID: 3072414333 Enrollment ID: O20040119000647 |
| Mailing Address | Practice Location Address |
|---|---|
| Charles Jay Vandenberg Iv, DO 1391 E Parkdale Ave, Manistee, MI 49660-9352 Ph: (231) 398-1760 | Charles Jay Vandenberg Iv, DO 1293 E Parkdale Ave, Manistee, MI 49660-8904 Ph: (231) 398-1840 |
Ryan A Sullivan, MD Internal Medicine Medicare: Accepting Medicare Assignments Practice Location: 2198 Us Highway 31 S, Manistee, MI 49660 Phone: 231-723-3567 |