Individual
PETER S VASIU
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
5070 CASCADE RD SE, SUITE 202, GRAND RAPIDS, MI 49546-8422
(616) 281-7000
(616) 281-7002
Mailing address
5070 CASCADE RD SE, SUITE 202, GRAND RAPIDS, MI 49546-8422
(616) 281-7000
(616) 281-7002
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
383468853
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2054102165
BLUE CROSS BLUE SHIELD
MI
01
—
383468853
TAX ID
MI
05
—
4521418
—
MI
Enumeration date
11/10/2005
Last updated
04/04/2014
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