Individual
AARON MATTHEW VANDREEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
401 W GREENLAWN AVE, LANSING, MI 48910
(517) 975-6382
Mailing address
3264 N EVERGREEN DR NE, GRAND RAPIDS, MI 49525-9746
(616) 353-7272
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
5101023841
MI
2085R0202X
Diagnostic Radiology Physician
H82893
MD
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
017440033
DC MEDICAID
DC
Enumeration date
03/23/2012
Last updated
04/02/2021
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