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Individual

DR. ANTHONY J VAN ES

Active
Sole proprietor

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
5082 LOVERS LN, PORTAGE, MI 49002-1557
(269) 381-0118
(269) 381-4610
Mailing address
5082 LOVERS LN, PORTAGE, MI 49002-1557
(269) 381-0118
(269) 381-4610

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
4301075616
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1230286
PHP NUMBER
MI
01
3503904892
BLUE CROSS PIN
MI
05
4217052
MI
01
4301075616
PHYSICIAN LICENSE
MI
01
P107191
BLUE CHOICE
MI
Enumeration date
01/16/2006
Last updated
03/07/2023
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