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Individual

DR. TIMOTHY GERARD VANDENBOOM II

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
5301 E HURON RIVER DR, YPSILANTI, MI 48197-1051
(734) 712-3161
Mailing address
24 FRANK LLOYD WRIGHT DR LBBY J2000, ANN ARBOR, MI 48105-9484
(734) 747-6766

Taxonomy

Speciality
Code
Description
License number
State
207ND0900X
Dermatopathology Physician
Primary
4301114577
MI
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
125062313
IL

Other

Enumeration date
03/29/2012
Last updated
04/26/2021
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