Organization
DERMATOLOGY CENTER OF GRAND RAPIDS PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. EVELYN E VANDERVEEN MD (PRESIDENT)
(616) 942-9343
Entity
Organization
Contact information
Practice address
750 E BELTLINE AVE NE, SUITE 301, GRAND RAPIDS, MI 49525-6049
(616) 942-9343
(616) 942-2538
Mailing address
750 E BELTLINE AVE NE, SUITE 301, GRAND RAPIDS, MI 49525-6049
(616) 942-9343
(616) 942-2538
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
—
—
207ND0101X
MOHS-Micrographic Surgery Physician
—
—
Other
Enumeration date
09/07/2005
Last updated
03/06/2015
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