Individual
DR. DOUGLAS R VANDERJAGT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
839 S PUTNAM ST, WILLIAMSTON, MI 48895-1623
(517) 655-3515
(855) 476-0189
Mailing address
3955 PATIENT CARE DR, LANSING, MI 48911-4299
(517) 374-7600
(885) 480-9150
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
5101013545
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0M21440018
MEDICARE ADVANTAGE
MI
01
—
1000922
MCLAREN HEALTH PLAN-COMMERCIAL
MI
01
—
110205373
RAILROAD MEDICARE
MI
01
—
1153302705
BCBS/BCN
MI
01
—
200000000943
PHP FAMILYCARE
MI
05
—
4218345
—
MI
05
—
4835895
—
MI
01
—
7256209
AETNA
MI
Enumeration date
06/12/2006
Last updated
03/24/2025
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