Individual
MR. SAMUEL DAVID VANDERWEIDE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
FNP-C
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
4704390634
MI
Other
Enumeration date
06/22/2026
Last updated
08/11/2026
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