Individual
JOSEPH YARED VANDEN BOSCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4100 LAKE DR SE, SUITE 305, GRAND RAPIDS, MI 49546
(616) 285-1377
(616) 285-1006
Mailing address
61 COMMERCE AVE SW, GRAND RAPIDS, MI 49503-4124
(616) 940-0660
(616) 940-1965
Taxonomy
Speciality
Code
Description
License number
State
208VP0014X
Interventional Pain Medicine Physician
Primary
4301066019
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0000197359804
UNITED HEALTH CARE
—
01
—
050076520
RAILROAD MEDICARE
—
01
—
175884
US DEPARTMENT OF LABOR
—
01
—
19944
HEALTH PLAN OF MICHIGAN
—
01
—
2011679
PHYSICIANS HEALTH PLAN
—
05
—
4532331-10
—
MI
05
—
4552933-10
—
MI
01
—
5211544
CIGNA
—
01
—
550411009
BCBSM
MI
01
—
7000027001
PRIORITY HEALTH MEDICAID
—
01
—
7944423
AETNA
—
Enumeration date
04/12/2006
Last updated
11/18/2008
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