Vanittersum, Koryn M

Vanittersum, Koryn M is an individual health care provider with primary practice located at 6401 Prairie St Suite 2600, Muskegon MI 49444. She recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as her primary health care specialty. Vanittersum, Koryn M can be contacted via phone (231) 727-7900.

Contact Information

Primary practice address
6401 Prairie St Suite 2600 Muskegon MI 49444
Fax: (231) 727-7914
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 4301076092 Michigan

Profile Details

NPI number 1699767897
LBN Legal business name Vanittersum, Koryn M
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 16th, 2005
Last updated Jun 20th, 2013 - about 11 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 1699767897 NPPES
Michigan Other N28430074 MEDICARE

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