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Individual
MICHELE D VAN DE MAE
Active
Individual
MICHELE D VAN DE MAE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
L9530
TX
208M00000X
Hospitalist Physician
L9530
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
168726101
—
TX
05
—
168726103
—
TX
01
—
8G4623
BCBS
TX
01
—
P00219597
RR MEDICARE
TX
Enumeration date
07/06/2006
Last updated
10/03/2024
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