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Individual

KIM STUART VAN DER VEER

Active
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Individual

KIM STUART VAN DER VEER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DC, CCSP

Taxonomy

Speciality
Code
Description
License number
State
111NS0005X
Sports Physician Chiropractor
Primary
X005017
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000445021001
BLUE SHIELD PROV. #
NY
01
0013200
GHI
NY
01
10019433
CDPHP PROV. #
NY
01
141690724-01
PRISM PROV. #
NY
01
566114
UNITED HEALTHCARE
NY
01
911601
ACN GROUP
NY
01
X3317
BCBS PROV. #
NY
Enumeration date
03/27/2006
Last updated
07/08/2007
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