Individual
MICHAEL VANDER MEULEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
75 FRANCIS ST, BOSTON, MA 02115-6110
(617) 732-8070
Mailing address
424 BROOKSIDE DR SE, GRAND RAPIDS, MI 49507-3558
(616) 648-7550
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
C171391
CA
207P00000X
Emergency Medicine Physician
Q3120
TX
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/20/2011
Last updated
01/09/2024
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