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Individual

DR. JEFFREY JOSEPH VANWINGEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
721 3 MILE RD NW, SUITE 200, GRAND RAPIDS, MI 49544-8229
(616) 647-3770
(616) 647-3776
Mailing address
721 3 MILE RD NW, SUITE 200, GRAND RAPIDS, MI 49544-8229
(616) 647-3770
(616) 647-3776

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
JV070262
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0804109762
BC/BS
05
4194806
MI
01
7976213
AETNA
MI
01
P106669
BLUE CARE NETWORK
MI
01
PH14829
PRIORITY HEALTH
MI
Enumeration date
06/29/2006
Last updated
04/15/2010
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