Individual
DR. JUAN GABRIEL VASQUEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3434 RIVERTOWN POINT CT SW, GRANDVILLE, MI 49418-3076
(616) 257-3344
(616) 257-1491
Mailing address
3434 RIVERTOWN POINT CT SW, GRANDVILLE, MI 49418-3076
(616) 257-3344
(616) 257-1491
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
5601102220
MI
207ND0900X
Dermatopathology Physician
Primary
5601102220
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
070D16223
BCBS OF MICHIGAN
MI
01
—
0D16223
MEDICARE GROUP
MI
01
—
CI2832
MEDICARE RAILROAD GROUP
MI
Enumeration date
05/03/2008
Last updated
07/30/2024
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