Organization
ANESTHESIA MEDICAL CONSULTANTS, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JAMES F VANDAM MD (EXECUTIVE DIRECTOR)
(616) 284-3100
Entity
Organization
Contact information
Practice address
3333 EVERGREEN DR NE, GRAND RAPIDS, MI 49525-9493
(616) 364-4200
(616) 364-7347
Mailing address
3333 EVERGREEN DR NE, GRAND RAPIDS, MI 49525-9493
(616) 364-4200
(616) 364-7347
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0D10782
BCBS GRP PIN - DOCS
MI
01
—
0D10783
BCBS GRP PIN - CRNAS
MI
Enumeration date
03/07/2011
Last updated
10/23/2012
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