Brent Ward Vandyke in Grand Rapids - Physician Assistant
Brent Ward Vandyke - NPI 1588651665
Brent Ward Vandyke is a Physician Assistant in Grand Rapids, Michigan. Brent Ward Vandyke practices all healthcare services and medical treatments related to Physician Assistant. The NPI Number for Brent Ward Vandyke is 1588651665. The last update date is 2022-08-26.
Brent Ward Vandyke's current location address is 4100 Lake Dr Se Ste 300, Grand Rapids, Michigan. You can contact this provider via phone number 6162678860. The mailing address for Brent Ward Vandyke is 4100 Lake Dr Se Ste 300, Grand Rapids, Michigan. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Brent Ward Vandyke |
|---|---|
| Address | 4100 Lake Dr Se Ste 300, Grand Rapids, Michigan |
| Phone Number | 6162678860 |
| Fax Number | |
| Sole Proprietor | N |
| Credentials | PA-C |
NPI Number Detail
| NPI Number | 1588651665 |
|---|---|
| Provider Enumeration Date | 2005-10-04 |
| Last Updated Date | 2022-08-26 |
Provider Mailing Address Detail
| Address | 4100 Lake Dr Se Ste 300 |
|---|---|
| City | Grand Rapids |
| State | Michigan (MI) |
| Post Code | 495468292 |
| Phone Number | 6162678860 |
| Fax Number |
Provider's Primary Taxonomy Detail
| Speciality | Physician Assistant |
|---|---|
| Taxonomy | 363A00000X |
| Licence No | 5601003590 |
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Definition: A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perfor |
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Post Comment/ Review Below
Could you provide the complete physical address where Brent Ward Vandyke is located?
The Brent Ward Vandyke is situated at the following address: 4100 Lake Dr Se Ste 300, Grand Rapids, MI, 495468292.
What is Brent Ward Vandyke's specialized area of practice, and what is the corresponding taxonomy classification code for this field?
The Brent Ward Vandyke's specialized field of practice is Physician Assistant, and the corresponding taxonomy code that categorizes this area of specialization is 363A00000X.
What is Brent Ward Vandyke's primary field of medical specialization, and what is the corresponding taxonomy classification code for this area of expertise?
The primary field of medical specialization for Brent Ward Vandyke is Physician Assistant, and the taxonomy classification code that categorizes this area of expertise is 363A00000X.
On what date did the Centers for Medicare & Medicaid Services assign the 1588651665 to Brent Ward Vandyke?
The Centers for Medicare & Medicaid Services assigned the 1588651665 to Brent Ward Vandyke on 2005-10-04.
When was the information related to Brent Ward Vandyke most recently updated or refreshed?
The details pertaining to the Brent Ward Vandyke, including its address, specialty, and other relevant information, were last updated or refreshed on 2022-08-26.