Organization
PORTAGE PODIATRY PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID A VANDERBIE DPM (PHYSICAN)
(269) 327-4447
Entity
Organization
Contact information
Practice address
1508 W CENTRE AVE, PORTAGE, MI 49024-5356
(269) 327-4447
(269) 327-3120
Mailing address
1508 W CENTRE AVE, PORTAGE, MI 49024-5356
(269) 327-4447
(269) 327-3120
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
5901001113
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1689800
—
MI
Enumeration date
06/19/2008
Last updated
06/19/2008
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