Individual
DR. WAYNE E VANDERKOLK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1045 GEZON PKWY SW, WYOMING, MI 49509-9542
(616) 456-5311
(616) 456-7955
Mailing address
1045 GEZON PKWY SW, WYOMING, MI 49509-9542
(616) 456-5311
(616) 456-7955
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
057820
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3360653
—
MI
Enumeration date
06/22/2005
Last updated
07/13/2018
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