Individual
MICHAEL JOSEPH VANVRANCKEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
11133 DUNN RD, SAINT LOUIS, MO 63136-6163
(314) 653-5630
(314) 653-4099
Mailing address
PO BOX 144333, ORLANDO, FL 32814-4333
(407) 422-9831
Taxonomy
Speciality
Code
Description
License number
State
207ZC0006X
Clinical Pathology Physician
MD.207945
LA
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
036.14361
IL
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
2017013308
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200042343
—
MO
Enumeration date
04/09/2010
Last updated
08/25/2021
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