Individual
DR. DOUGLAS M VANDRIE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
555 MIDTOWNE STREET NE, SUITE 450, GRAND RAPIDS, MI 49503-5732
(616) 588-1800
(616) 588-1850
Mailing address
555 MIDTOWNE STREET NE, SUITE 400, GRAND RAPIDS, MI 49503-5731
(616) 588-1800
(616) 588-1850
Taxonomy
Speciality
Code
Description
License number
State
207VF0040X
Urogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician
Primary
4301037779
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1332800
—
MI
Enumeration date
07/27/2006
Last updated
09/27/2013
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