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Contact Information

MICHAEL H VANDERLICK, MD
4801 AMBASSADOR CAFFERY PKWY
LAFAYETTE, LA70508
 Phone: 337-470-2605
 Fax: 337-470-4595
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Hospitalist

208M00000X
 

Internal Medicine

207R00000X 11 Physician/Internal Medicine
Indicates primary specialty

NPI Profile & details for MICHAEL H VANDERLICK · (Male)

NPI # 1598791691
Status Active
Credentials MD
Entity Individual
Enumeration date 06/23/2006
Last updated 05/17/2021 - About 5 years ago
Sole proprietor 1 No
Identifiers
  • LA License # 14489R
  • LA License # MD.14489R
  • LA Medicaid 1120561
Hospital affiliation(s)
  • OUR LADY OF LOURDES REGIONAL MEDICAL CENTER INC - (Acute Care)
    4801 AMBASSADOR CAFFERY PARKWAY
    LAFAYETTE, LA 70508
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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