Mark Vandermyde in Portage - Physician Assistant
Mark Vandermyde - NPI 1568543502
Mark Vandermyde is a Physician Assistant in Portage, Michigan. Mark Vandermyde practices all healthcare services and medical treatments related to Physician Assistant. The NPI Number for Mark Vandermyde is 1568543502. The last update date is 2007-07-08.
Mark Vandermyde's current location address is 7901 Angling Rd, Portage, Michigan. You can contact this provider via phone number 2693248405. The mailing address for Mark Vandermyde is 7901 Angling Rd, Portage, Michigan. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Mark Vandermyde |
|---|---|
| Address | 7901 Angling Rd, Portage, Michigan |
| Phone Number | 2693248405 |
| Fax Number | |
| Sole Proprietor | N |
| Credentials | -- |
NPI Number Detail
| NPI Number | 1568543502 |
|---|---|
| Provider Enumeration Date | 2006-10-18 |
| Last Updated Date | 2007-07-08 |
Provider Mailing Address Detail
| Address | 7901 Angling Rd |
|---|---|
| City | Portage |
| State | Michigan (MI) |
| Post Code | 490240714 |
| Phone Number | 2693248405 |
| Fax Number |
Provider's Primary Taxonomy Detail
| Speciality | Physician Assistant |
|---|---|
| Taxonomy | 363A00000X |
| Licence No | 5601003052 |
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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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Where is the Mark Vandermyde located?
The Mark Vandermyde is located at 7901 Angling Rd, Portage, MI 490240714.
When was the Mark Vandermyde's 1568543502 issued?
The Mark Vandermyde's 1568543502 was issued on 2006-10-18.
On what date did the Centers for Medicare & Medicaid Services issue the 1568543502 to Mark Vandermyde?
The Mark Vandermyde received its 1568543502 assignment from the Centers for Medicare & Medicaid Services on 2006-10-18.
When was the Mark Vandermyde's information last updated?
The Mark Vandermyde's information was last updated on 2007-07-08.
When was the information pertaining to Mark Vandermyde most recently updated or revised?
The details related to Mark Vandermyde, including its address, specialty, and other relevant information, were last updated or revised on 2007-07-08.
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