Individual
DR. DOUGLAS J WUNDERLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
601 JOHN ST, STE 100, KALAMAZOO, MI 49007-5341
(269) 373-1592
(269) 373-6270
Mailing address
601 JOHN ST, BOX 42, KALAMAZOO, MI 49007-5341
(269) 373-1592
(269) 373-6270
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
4301405380
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1417961137
BCBSM - BRONSON
MI
05
—
1952321952
—
MI
Enumeration date
07/20/2006
Last updated
11/27/2023
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