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Individual

MATTHEW VERCAUTEREN

Active
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Individual

MATTHEW VERCAUTEREN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PA

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
5601006429
MI
363A00000X
Physician Assistant
Primary
MA056784
PA
363AS0400X
Surgical Physician Assistant
5601006429
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0H231320
BLUE CROSS GROUP
MI
Enumeration date
10/04/2012
Last updated
08/12/2014
About Stedi
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