# MICHAEL H. VANDERLICK M.D. APMC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1891725867
- **Authorized official:** DR. MICHAEL HENRY VANDERLICK M.D. (CHIEF EXECUTOR)
- **Authorized official phone:** (337) 291-1162

## Contact information

- **Practice address:** 601 W SAINT MARY BLVD, STE. 210, LAFAYETTE, LA 70506-3568
- **Practice address phone:** (337) 291-1162
- **Practice address fax:** (337) 264-1499
- **Mailing address:** 601 W SAINT MARY BLVD, STE. 210, LAFAYETTE, LA 70506-3568
- **Mailing address phone:** (337) 291-1162
- **Mailing address fax:** (337) 264-1499

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207R00000X | Internal Medicine Physician | 14489R | LA | Yes |

## Other

- **Enumeration date:** 07/04/2006
- **Last updated:** 09/30/2008