Individual
JOSHUA VANDERWALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
8906 M 89, RICHLAND, MI 49083-9540
(269) 286-7130
Mailing address
601 JOHN STREET, BOX 39, KALAMAZOO, MI 49007
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
4301502346
MI
207Q00000X
Family Medicine Physician
4301502346
MI
Other
Enumeration date
04/29/2016
Last updated
08/17/2023
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