Individual
TIMOTHY VANEVERY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2061 M 119, PETOSKEY, MI 49770-8914
(231) 487-2020
(231) 487-6166
Mailing address
2061 M 119, PETOSKEY, MI 49770-8914
(231) 487-2020
(231) 487-6166
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
TV039837
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1802400101
BLUE CROSS BLUE SHIELD
MI
01
—
7000020101
PRIORITY HEALTH
MI
Enumeration date
08/10/2006
Last updated
07/08/2007
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