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Individual

DR. JOEL THOMAS VANDER LUGT

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M. D.

Contact information

Practice address
3264 N EVERGREEN DR NE, GRAND RAPIDS, MI 49525-9746
(616) 363-7272
Mailing address
3264 N EVERGREEN DR NE, GRAND RAPIDS, MI 49525-9746
(616) 363-7339

Taxonomy

Speciality
Code
Description
License number
State
2085R0204X
Vascular & Interventional Radiology Physician
Primary
4301099266
MI
390200000X
Student in an Organized Health Care Education/Training Program

Other

Enumeration date
06/13/2008
Last updated
01/27/2023
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