| Mark Leroy Vanderweide, CRNA | |
|
14700 Lake Shore Dr, Charlevoix, MI 49720-1999 | |
| (231) 547-4024 | |
| Not Available |
| Full Name | Mark Leroy Vanderweide |
|---|---|
| Gender | Male |
| Speciality | Certified Registered Nurse Anesthetist (crna) |
| Experience | 4 Years |
| Location | 14700 Lake Shore Dr, Charlevoix, 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 |
|---|---|---|---|
| 1225758824 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 367500000X | Nurse Anesthetist, Certified Registered | 4704293836 (Michigan) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Charlevoix Area Hospital | Charlevoix, MI | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Munson Healthcare Charlevoix Hospital | 4284528035 | 43 |
| Entity Name | Munson Healthcare Charlevoix Hospital |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1326124058 PECOS PAC ID: 4284528035 Enrollment ID: O20040211001170 |
| Mailing Address | Practice Location Address |
|---|---|
| Mark Leroy Vanderweide, CRNA 854 Dorroll St Ne, Grand Rapids, MI 49505-4209 Ph: (616) 914-6532 | Mark Leroy Vanderweide, CRNA 14700 Lake Shore Dr, Charlevoix, MI 49720-1999 Ph: (231) 547-4024 |
Michael C Macmillan, CRNA Nurse Anesthetist - CR Medicare: Medicare Enrolled Practice Location: 12375 Indian Place Dr, Charlevoix, MI 49720 Phone: 231-547-2496 Fax: 231-547-2823 | |
Michael Johnson, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 14700 Lake Shore Dr, Charlevoix, MI 49720 Phone: 231-547-4024 Fax: 231-547-8088 | |
Jennifer L Simons, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 14700 Lake Shore Dr, Charlevoix, MI 49720 Phone: 231-547-4024 | |
Mel Choponis, CRNA Nurse Anesthetist - CR Medicare: Not Enrolled in Medicare Practice Location: 14700 Lake Shore Dr, Charlevoix, MI 49720 Phone: 231-547-4024 Fax: 231-547-8088 | |
Kenneth Forrester, CRNA Nurse Anesthetist - CR Medicare: Medicare Enrolled Practice Location: 14700 Lake Shore Dr, Charlevoix, MI 49720 Phone: 231-547-4024 Fax: 231-547-8088 | |
Madeline Jeakle Nemes, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 14700 Lake Shore Dr, Charlevoix, MI 49720 Phone: 231-547-4024 |