Organization
DAVID VANDAM LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID VAN DAM CRNA (OWNER)
(248) 421-5876
Entity
Organization
Contact information
Practice address
5130 COOLIDGE HWY, SUITE 120, ROYAL OAK, MI 48073-1001
(248) 658-0878
(248) 435-0930
Mailing address
6985 MILLER DR, WARREN, MI 48092-4725
(586) 264-3500
(586) 264-3495
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
4704115131
MI
Other
Enumeration date
08/02/2013
Last updated
11/11/2013
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