# DR. ANTONIO VASQUEZ

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1568569739
- **Gender:** Man
- **Credential:** MD

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 2086S0129X | Vascular Surgery Physician | AV034932 | MI | Yes |

## Other

- **Enumeration date:** 09/20/2006
- **Last updated:** 07/08/2007

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 00990150332 | BCBS | MI |
| 01 | — | 11291166 | CAQH | MI |
| 05 | — | 1325154 | — | MI |