Vervaeke, Rudy Jerome

Vervaeke, Rudy Jerome is an individual health care provider with primary practice located at 21420 Harper Ave Suite 2, Saint Clair Shores MI 48080-3607. He recently has only one registered license in Allopathic & Osteopathic Physicians / Addiction Medicine, which is considered as his primary health care specialty. Vervaeke, Rudy Jerome can be contacted via phone (586) 775-7400.

Contact Information

Primary practice address
21420 Harper Ave Suite 2 Saint Clair Shores MI 48080-3607
Phone: (586) 775-7400
Fax: (586) 775-0091
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Addiction Medicine 207RA0401X 4301044898 Michigan

Profile Details

NPI number 1922108927
LBN Legal business name Vervaeke, Rudy Jerome
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 22nd, 2006
Last updated Nov 20th, 2015 - about 9 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 1922108927 NPPES
Michigan MEDICAID 4842512-10
Michigan Other 352263519
Michigan Other 1105018171

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