Organization
AMC MOBILE ANESTHESIA, PC
Active
Parent organization
WEST MICHIGAN ANESTHESIA ANESTHESIA, PC
Other names
AMC Mobile
Organization subpart
Yes
Provider details
NPI number
Legal business name
WEST MICHIGAN ANESTHESIA ANESTHESIA, PC
Authorized official
DR. JAMES F VANDAM MD (EXECUTIVE DIRECTOR)
(616) 284-3100
Entity
Organization
Contact information
Practice address
3333 EVERGREEN DR NE, GRAND RAPIDS, MI 49525-9493
(616) 284-3180
(616) 284-3181
Mailing address
3333 EVERGREEN DR NE, GRAND RAPIDS, MI 49525-9493
(616) 284-3180
(616) 284-3181
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0D10334
BCBS GRP PIN
MI
Enumeration date
04/01/2010
Last updated
10/23/2012
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