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Individual

DAVID AARON VANDYKE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
100 MICHIGAN ST NE, SUITE A721, GRAND RAPIDS, MI 49503-2560
(616) 391-3139
(616) 391-3044
Mailing address
100 MICHIGAN ST NE, MC 845, GRAND RAPIDS, MI 49503-2560
(616) 486-6795
(616) 486-6675

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
4301097546
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
19568
RESIDENT PERMIT
MN
Enumeration date
05/05/2008
Last updated
03/02/2021
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