Individual
MICHAEL VANANTWERP
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
320 E HIGHWAY 50, O FALLON, IL 62269-2704
(888) 577-6337
Mailing address
320 E HIGHWAY 50, O FALLON, IL 62269-2704
(888) 577-6337
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
036.158946
IL
207P00000X
Emergency Medicine Physician
4301506138
MI
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/23/2019
Last updated
06/15/2022
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