Individual
GERRIT VANDERLUGT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
224 N MILL ST, SAINT LOUIS, MI 48880-1523
(989) 681-3524
(989) 681-2683
Mailing address
224 N MILL ST, SAINT LOUIS, MI 48880-1523
(989) 681-3524
(989) 681-2683
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
5101007721
MI
208D00000X
General Practice Physician
GV007721
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0852914964
BCBSM
MI
01
—
0983154
HEALTHPLUS COMMERCIAL
MI
01
—
1020574
MCLAREN HEALTH PLAN
MI
05
—
114893389
—
MI
01
—
200000005905
PHP COMMERCIAL
MI
Enumeration date
07/01/2005
Last updated
06/26/2012
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