| Peter S. Vandemark, Md, Pc | |
|
705 Oak Street Suite 11 Big Rapids MI 49307 | |
| (231) 796-4406 | |
| (231) 796-2770 |
| Full Name | Peter S. Vandemark, Md, Pc |
|---|---|
| Speciality | Internal Medicine |
| Location | 705 Oak Street, Big Rapids, Michigan |
| Authorized Official Name and Position | Peter S Vandemark (PRESIDENT/OWNER) |
| Authorized Official Contact | 2317964406 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Peter S. Vandemark, Md, Pc 705 Oak Street Suite 11 Big Rapids MI 49307 Ph: (231) 796-4406 | Peter S. Vandemark, Md, Pc 705 Oak Street Suite 11 Big Rapids MI 49307 Ph: (231) 796-4406 |
| NPI Number | 1376643155 |
|---|---|
| Provider Enumeration Date | 09/22/2006 |
| Last Update Date | 07/25/2007 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1376643155 | NPI | - | NPPES |
| 3377875 | Medicaid | MI | |
| 0540004 | Other | MI | BLUE CROSS BLUE SHIELD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 4301038966 (Michigan) | Primary |
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