Individual
MICHAEL GABRIEL VANDERLOO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
4209 LINCOLN RD, HATTIESBURG, MS 39402-3065
(601) 579-5400
(601) 579-5240
Mailing address
415 S 28TH AVE, HATTIESBURG, MS 39401-7246
(601) 579-5400
(601) 579-5240
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
26911
MS
Other
Enumeration date
04/03/2018
Last updated
07/15/2021
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