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Organization

DERMATOLOGY CENTER OF GRAND RAPIDS PC

Active
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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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