Organization
RUDY J VERVAEKE MD PLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RUDY JEROME VERVAEKE M.D. (CEO)
(586) 775-7400
Entity
Organization
Contact information
Practice address
24211 LITTLE MACK AVE, SAINT CLAIR SHORES, MI 48080-1151
(586) 775-7400
(586) 775-0091
Mailing address
24211 LITTLE MACK AVE, SAINT CLAIR SHORES, MI 48080-1151
(586) 775-7400
(586) 775-0091
Taxonomy
Speciality
Code
Description
License number
State
207RA0401X
Addiction Medicine (Internal Medicine) Physician
Primary
4301044898
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
770666348
COMMERCIAL
MI
Enumeration date
12/26/2006
Last updated
08/18/2008
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