Individual
JAMES CRAIG VANDEWALL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
415 N 8TH ST, OLEAN, NY 14760-2237
(716) 372-9399
(716) 373-5530
Mailing address
415 N 8TH ST, P.O. BOX 1208, OLEAN, NY 14760-6208
(716) 372-9399
(716) 373-5530
Taxonomy
Speciality
Code
Description
License number
State
207RR0500X
Rheumatology Physician
195467
NY
207RR0500X
Rheumatology Physician
Primary
195467-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01482237
—
NY
01
—
P00079354
RR MEDICARE
NY
Enumeration date
06/23/2005
Last updated
07/05/2023
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