Individual
DR. MICHAEL JAMES VREDEVOOGD
Active
Individual
DR. MICHAEL JAMES VREDEVOOGD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D.
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
Primary
63010006531
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
680EO1478
BLUE CROSS BLUE SHIELD
MI
Enumeration date
01/09/2007
Last updated
07/08/2007
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