Vandermyde, Mark

Vandermyde, Mark is an individual health care provider with primary practice located at 7901 Angling Rd , Portage MI 49024-0714. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as his primary health care specialty. Vandermyde, Mark can be contacted via phone (269) 324-8405.

Contact Information

Primary practice address
7901 Angling Rd Portage MI 49024-0714
Phone: (269) 324-8405
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 5601003052 Michigan

Profile Details

NPI number 1568543502
LBN Legal business name Vandermyde, Mark
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 18th, 2006
Last updated Jul 8th, 2007 - about 17 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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