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Contact Information

JACOB VANDERSTARRE, MD
890 OAK ST SE BLDG A
SALEM, OR97301
 Phone: 855-691-9890
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Emergency Medicine

207P00000X 93 Physician/Emergency Medicine
Indicates primary specialty

NPI Profile & details for JACOB VANDERSTARRE · (Male)

NPI # 1003267782
Status Active
Credentials MD
Entity Individual
Enumeration date 06/24/2016
Last updated 06/21/2019 - About 7 years ago
Sole proprietor 1 No
Identifiers
  • MI License # 4301109907
  • OR License # MD191574
Hospital affiliation(s)
  • BRONSON BATTLE CREEK HOSPITAL - (Acute Care)
    300 NORTH AVENUE
    BATTLE CREEK, MI 49017
  • BRONSON LAKEVIEW HOSPITAL - (Critical Access)
    408 HAZEN STREET
    PAW PAW, MI 49079
  • BRONSON METHODIST HOSPITAL - (Acute Care)
    601 JOHN STREET 42
    KALAMAZOO, MI 49007
  • SOUTH HAVEN COMMUNITY HOSPITAL - (Acute Care)
    955 S BAILEY AVE
    SOUTH HAVEN, MI 49090
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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