Vanderlugt, Philip J

Vanderlugt, Philip J is an individual health care provider with primary practice located at 750 E Beltline Ave Ne , Grand Rapids MI 49525-6049. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Vanderlugt, Philip J can be contacted via phone (616) 949-2600.

Contact Information

Primary practice address
750 E Beltline Ave Ne Grand Rapids MI 49525-6049
Phone: (616) 949-2600
Fax: (616) 365-2076
Website:
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Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optometrist 152W00000X 4901003840 Michigan

Profile Details

NPI number 1942204623
LBN Legal business name Vanderlugt, Philip J
Credentials Doctor of Optometry (OD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 9th, 2005
Last updated Jun 9th, 2008 - about 16 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1942204623 NPPES
Michigan MEDICAID 3287482
Michigan Other 410034271
Michigan Other 900D16547

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