Individual
DR. MICHAEL HENRY VANDERLICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4801 AMBASSADOR CAFFERY PKWY, LAFAYETTE, LA 70508
(337) 470-2605
(337) 470-4595
Mailing address
5959 S SHERWOOD FOREST BLVD, BATON ROUGE, LA 70816-6038
(225) 526-0011
(225) 765-9196
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
14489R
LA
208M00000X
Hospitalist Physician
Primary
MD.14489R
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1120561
—
LA
Enumeration date
06/23/2006
Last updated
05/17/2021
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