Vangelderen, Jeffrey Theodore

Vangelderen, Jeffrey Theodore is an individual health care provider with primary practice located at 248 Washington Ave Suite A, Bay City MI 48708-5848. He recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as his primary health care specialty. Vangelderen, Jeffrey Theodore can be contacted via phone (989) 892-5664.

Contact Information

Primary practice address
248 Washington Ave Suite A Bay City MI 48708-5848
Phone: (989) 892-5664
Fax: (989) 892-0662
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 4301405970 Michigan

Profile Details

NPI number 1043217979
LBN Legal business name Vangelderen, Jeffrey Theodore
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 7th, 2005
Last updated Dec 19th, 2023 - about 2 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 1043217979 NPPES
Michigan MEDICAID 3418136
Michigan MEDICAID 3419062

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