Individual
JOHN G VANDERFORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
16001 W 9 MILE RD, SOUTHFIELD, MI 48075-4818
(248) 849-3000
Mailing address
212 W LINCOLN ST, BIRMINGHAM, MI 48009-1960
Taxonomy
Speciality
Code
Description
License number
State
207PE0004X
Emergency Medical Services (Emergency Medicine) Physician
Primary
5101010489
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
113374659
—
MI
05
—
114298954
—
MI
05
—
114357957
—
MI
01
—
5101010489
MEDICAL LICENSE
MI
01
—
JV010489
BC/BS OF MICHIGAN
MI
Enumeration date
06/07/2006
Last updated
02/02/2013
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